Management of patients with electrical storm at Kyorin University.

Electrical storm (ES) refers to a life-threatening state of cardiac electrical instability, and occurrence of three or more episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) within 24-h period. Contemporary management extends beyond antiarrhythmic therapy and catheter ablation to include autonomic modulation, rehabilitation, and longitudinal patient engagement. We present two illustrative cases: one with non-ischemic cardiomyopathy with refractory VT storm, and the other with post-myocardial infarction VF storm, to demonstrate a practical stepwise management framework from acute stabilization to long-term surveillance. These cases highlight the importance of early sedation, optimized pharmacologic therapy, neuromodulation, tailored ablation strategies, rehabilitation, and structured continuity of care.