Document Detail


Effect of cardiac resynchronization therapy on the incidence of electrical storm.
MedLine Citation:
PMID:  19359057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hemodynamic improvement from biventricular pacing is well documented; however, its electrophysiologic effects have not been systematically studied. In this study, incidence and risk factors for electrical storm (ES) were investigated in 729 ICD and biventricular defibrillator (CRT-D) heart failure patients.
METHODS: 168 consecutive CRT-D and 561 ICD patients were retrospectively analyzed for the occurrence of VT/VF and predisposing factors. Electrical storm was defined as ventricular tachycardia or fibrillation ≥3 times during 24 h. Mean follow-up was 41 months.
RESULTS: In 168 CRT-D patients only one patient experienced electrical storm compared to 39 patients out of 561 ICD patients (0.6% vs. 7%, p<0.01). 33% of the patients with electrical storm died within one year. In the CRT-D group 81 patients (48%) developed VT or VF and received at least one appropriate therapy, compared to 281 patients (50%) in the ICD group. Mean ejection fraction was 21.7% in the CRT-D group and 34.7% (p<0.01) in the ICD group. Stratifying the patients according to primary or secondary prevention and ejection fraction demonstrated that VT/VF clusters were significantly associated with ICD indication for secondary prevention, previous myocardial infarction and LVEF<30%.
CONCLUSION: The development of electrical storm is accompanied with a highly increased mortality risk even if an ICD/CRT-D is implanted. In CRT-D patients electrical storm is much less common than in ICD patients. Secondary prevention and ejection fraction<30% are predictors of electrical storm. Beside hemodynamic improvements cardiac resynchronization therapy may reduce the arrhythmia burden in heart failure patients.
Authors:
Peter Nordbeck; Bernhard Seidl; Beatrix Fey; Wolfgang R Bauer; Oliver Ritter
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Publication Detail:
Type:  Journal Article     Date:  2009-04-08
Journal Detail:
Title:  International journal of cardiology     Volume:  143     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  330-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Internal Medicine I, University Hospital Würzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Resynchronization Therapy / mortality*,  statistics & numerical data
Female
Follow-Up Studies
Heart Failure / mortality*,  therapy*
Humans
Incidence
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Survival Analysis
Tachycardia, Ventricular / mortality*,  prevention & control
Ventricular Fibrillation / mortality*,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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