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October 26, 2016Journal of Cardiovascular Electrophysiology

Beyond the Storm: Comparison of Clinical Factors, Arrhythmogenic Substrate, and Catheter Ablation Outcomes in Structural Heart Disease Patients With versus Those Without a History of Ventricular Tachycardia Storm

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Why the study?

Does VT storm presentation worsen outcomes in structural heart disease patients undergoing catheter ablation compared to nonstorm presentation?

Population

923 consecutive patients with ischemic or nonischemic cardiomyopathy and sustained monomorphic VT presenting…

Comparison

Catheter ablation in patients presenting with VT… vs Catheter ablation in patients presenting with…

Design

Cohort

Follow-up

12 months

Key result

Nonischemic cardiomyopathy patients presenting with VT storm for catheter ablation had worse 12-month VA-free survival than nonstorm patients (36% vs. 47%, P=0.004), unlike ischemic patients.

Authors

SKSaurabh KumarAFAkira FujiiSKSunil Kapur

Discussion

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Member takes

Overview

VT storm presentation was associated with worse ablation outcomes in nonischemic cardiomyopathy; leaves open etiology-specific risk stratification and targeted interventions.

Study Design

Type

Cohort (n=923)

Structured PICO

Does VT storm presentation worsen outcomes in structural heart disease patients undergoing catheter ablation compared to nonstorm presentation?

P
Population
923 consecutive patients with ischemic (ICM; n=554) or nonischemic cardiomyopathy (NICM; n=369) and sustained monomorphic VT presenting for catheter ablation.
I
Intervention
Catheter ablation in patients presenting with VT storm (ICM storm n=186; NICM storm n=101)
C
Comparator
Catheter ablation in patients presenting with nonstorm VT
O
Outcome
12-month ventricular arrhythmia (VA)-free survival and survival free of death/transplanthard clinical

Main Result

Absolute Event Rate: 36% vs 47%

p-value: p=0.004

VT storm presentation is associated with worse clinical outcomes following catheter ablation in patients with nonischemic cardiomyopathy, but not in those with ischemic cardiomyopathy.

Cite This Study

Kumar et al. (2016) conducted a cohort in Sustained monomorphic ventricular tachycardia in structural heart disease (n=923). VT storm presentation vs. Nonstorm presentation was evaluated on 12-month ventricular arrhythmia-free survival (NICM cohort) (p=0.004). Nonischemic cardiomyopathy patients presenting with VT storm for catheter ablation had worse 12-month VA-free survival than nonstorm patients (36% vs. 47%, P=0.004), unlike ischemic patients.

synapsesocial.com/papers/6a0f61608090e499da5fbbdbhttps://doi.org/10.1111/jce.13117
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