ECG CASES COLUMNAn Electrical Storm Is Coming! Ventricular Storm Case StudySweeney, Michael MSN, BSN, FNP-BC, ENP-BC, NE-BC, CEN, CCRN, CFRN, CNRN; Eldrich, Samuel MDEditor(s): Colio, Pedro PhD, DNP, ENP-C, FNP-C, Column Editor Author Information Chestnut Hill Hospital, Philadelphia, Pennsylvania. Corresponding Author: Michael Sweeney, MSN, BSN, FNP-BC, ENP-BC, NE-BC, CEN, CCRN, CFRN, CNRN, Chestnut Hill Hospital, 8835 Germantown Pike, Philadelphia, PA 19144 ([email protected]). Disclosure: The authors report no conflicts of interest. Advanced Emergency Nursing Journal: October/December 2022 - Volume 44 - Issue 4 - p 302-311 doi: 10.1097/TME.0000000000000432 Buy Metrics Abstract A 65-year-old man presented to the emergency department (ED) for evaluation of epigastric and chest pain. On presentation, a 12-lead electrocardiogram revealed a patient in rapid atrial fibrillation (AFib) with anteroseptal myocardial infarction. Treatment of ST-elevation myocardial infarction (STEMI) and rapid AFib were initiated, and the patient was flown to a regional percutaneous coronary intervention center. Two weeks later, the patient presented to the same ED with a LifeVest external defibrillator (Zoll Medical, Chelmsford, MA). The patient received electrical shock in excess of 10 times from the LifeVest prior to ED arrival where he promptly developed ventricular tachycardia (VT). After cardioversion, the VT storm persisted and required multiple cardioversions, resuscitation, intubation, and transfer back to a tertiary cardiac center for electrophysiology studies and internal cardiac defibrillator placement. This case explores the course of a patient's anteroseptal infarction, utilization and description of the LifeVest external defibrillator, and the subsequent visit to the ED in VT storm. It provides insight into the team approach, decision-making process, and managing a complex medical illness. Furthermore, it helps identify methods for emergency providers to improve their approach in both complex and rare cases. © 2022 Wolters Kluwer Health, Inc. All rights reserved.