Successful ventricular tachycardia ablation in patients with electrical storm reduces recurrences and improves survival

Pasquale Vergara, Roderick Tung, Marmar Vaseghi, Chiara Brombin, David Frankel, Luigi Di Biase, Koichi Nagashima, Usha Tedrow, Wendy S. Tzou, William H. Sauer, Nilesh Mathuria, Shiro Nakahara, Kairav Vakil, Venkat Tholakanahalli, T. Jared Bunch, J. Peter Weiss, Timm Dickfeld, Rama Vunnam, Dhanunjaya Lakireddy, J. David BurkhardtAnna Correra, Pasquale Santangeli, David Callans, Andrea Natale, Francis Marchlinski, William G. Stevenson, Kalyanam Shivkumar, Paolo Della Bella

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Objective: The purpose of this study was to evaluate the characteristics and outcome of patients undergoing ablation after electrical storm (ES). Methods: Clinical and procedural characteristics, ventricular tachycardia (VT) recurrence, and mortality rates from 1940 patients undergoing VT ablation were compared between patients with and without ES. Results: The group of 677 patients with ES (34.9%) were older, were more frequently men, and had a lower ejection fraction, more advanced heart failure, and a higher prevalence of cardiovascular comorbidities as compared with those without ES (86.1% patients with ES had ≥2 comorbidities vs 71.4%; P <.001). Patients with ES had more inducible VTs (2.5 ± 1.8 vs 1.9 ± 1.9; P <.001), required longer procedures (296.1 ± 119.1 minutes vs 265.7 ± 110.3 minutes; P <.001), and had a higher in-hospital mortality (42 deaths [6.2%] vs 18 deaths [1.4%]; P <.001). At 1-year follow-up, patients with ES experienced a higher risk of VT recurrence and mortality (32.1% vs 22.6% and 20.1% vs 8.5%; long-rank, P <.001 for both). Among patients with ES, those without any inducible VT after ablation had a higher survival rate (86.3%) than did those with nonclinical VTs only (72.9%), those with clinical VTs inducible at programmed electrical stimulation (51.2%), and not-tested patients (65.0%) (long-rank, P <.001 for all). In multivariate analysis, ES remained an independent predictor of in-hospital mortality, VT recurrence, and 1-year mortality (P <.001). Conclusion: Patients with ES have a high risk of VT recurrence and mortality. Patient and procedure characteristics are consistent with advanced cardiac disease and longer and more complex procedures. In patients with ES, acute procedural success is associated with a significant reduction in VT recurrence and improved 1-year survival.

Original languageEnglish (US)
Pages (from-to)48-55
Number of pages8
JournalHeart Rhythm
Volume15
Issue number1
DOIs
StatePublished - Jan 2018

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Successful ventricular tachycardia ablation in patients with electrical storm reduces recurrences and improves survival'. Together they form a unique fingerprint.

  • Cite this

    Vergara, P., Tung, R., Vaseghi, M., Brombin, C., Frankel, D., Di Biase, L., Nagashima, K., Tedrow, U., Tzou, W. S., Sauer, W. H., Mathuria, N., Nakahara, S., Vakil, K., Tholakanahalli, V., Bunch, T. J., Weiss, J. P., Dickfeld, T., Vunnam, R., Lakireddy, D., ... Della Bella, P. (2018). Successful ventricular tachycardia ablation in patients with electrical storm reduces recurrences and improves survival. Heart Rhythm, 15(1), 48-55. https://doi.org/10.1016/j.hrthm.2017.08.022