Catheter ablation acutely suppressed electrical storm in 84% of patients with structural heart disease, with 48% remaining free of any ventricular tachycardia over a mean 18-month follow-up.
Observational (n=50)
Does catheter ablation improve acute and long-term suppression of electrical storm in patients with structural heart disease?
Catheter ablation is highly effective for the acute suppression of electrical storm in patients with structural heart disease and prevents long-term ventricular tachycardia recurrence in approximately half of treated patients.
AIMS: Electrical storm (ES) adversely affects prognosis of patients and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES. METHODS AND RESULTS: Fifty consecutive patients with coronary artery disease (38), idiopathic dilated cardiomyopathy (5), arrhythmogenic right ventricular cardiomyopathy (6), and/or with combined aetiology (1) underwent CA for ES. Mean left ventricular ejection fraction (LVEF) was 29 ± 11%. All patients underwent electroanatomical mapping, and CA was performed to abolish all inducible ventricular arrhythmias. The ES was suppressed by CA in 84% of patients. During the follow-up of 18 ± 16 months, 24 patients had no recurrences of any ventricular tachycardia (VT; 48%). Repeated procedure was necessary to suppress the recurrent ES in 13 cases (26%). Statistical analysis revealed that low LVEF (22 ± 3 vs. 31 ± 12%; P < 0.001), increased LVend-diastolic diameter (72 ± 9.1 vs. 64 ± 8.9 mm; P = 0.0135), and renal insufficiency (P < 0.001) were the univariate predictors of early mortality or necessity for heart transplantation. Recurrence of ES despite previous CA procedure was associated with a higher risk of death or heart transplant during follow-up (P < 0.05). CONCLUSION: Catheter ablation is effective in acute suppression of ES and often represents a life-saving therapy. In the long term, it prevents recurrences of any VT in about half of the treated patients.
Koželuhová et al. (2010) conducted an observational in Electrical storm in patients with structural heart disease (n=50). Catheter ablation was evaluated on Acute suppression of electrical storm. Catheter ablation acutely suppressed electrical storm in 84% of patients with structural heart disease, with 48% remaining free of any ventricular tachycardia over a mean 18-month follow-up.