In electrical storm management, what nonpharmacologic measure may help reduce sympathetic drive?

• A. Sedation
• B. Increase caffeine
• C. High-intensity exercise
• D. Sleep deprivation

Answer: (A)

Reducing sympathetic drive is the goal because heightened sympathetic activity promotes ventricular arrhythmias during an electrical storm. Sedation helps achieve this by calming agitation, pain, and anxiety, which lowers central nervous system outflow and reduces circulating catecholamines. With less sympathetic stimulation, the myocardium is less prone to triggered activity and instability, leading to a lower arrhythmia burden and improved hemodynamics. Sedation also decreases heart rate and myocardial oxygen demand, further stabilizing the patient during a storm. Caffeine, sleep deprivation, and intense exercise would all raise sympathetic tone and could worsen the situation, making sedation the best option among the choices.