Electrical storms in patients with an implantable cardioverter defibrillator
In some patients with an implantable cardioverter defibrillator (ICD), multiple episodes of electrical storm (ES) can occur. We assessed the prevalence, features, and predictors of ES in patients with ICD. Eighty-five patients with an ICD were analyzed. ES was defined as the occurrence of two or mor...
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Published in | Yonsei medical journal Vol. 52; no. 1; pp. 26 - 32 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Korea (South)
Yonsei University College of Medicine
01.01.2011
연세대학교의과대학 |
Subjects | |
Online Access | Get full text |
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Summary: | In some patients with an implantable cardioverter defibrillator (ICD), multiple episodes of electrical storm (ES) can occur. We assessed the prevalence, features, and predictors of ES in patients with ICD.
Eighty-five patients with an ICD were analyzed. ES was defined as the occurrence of two or more ventricular tachyarrhythmias within 24 hours.
Twenty-six patients experienced at least one ES episode, and 16 patients experienced two or more ES episodes. The first ES occurred 209 ± 277 days after ICD implantation. In most ES cases, the index arrhythmia was ventricular tachycardia (65%). There were no obvious etiologic factors at the onset of most ES episodes (57%). More patients with a structurally normal heart (p = 0.043) or ventricular fibrillation (VF) as the index arrhythmia (p = 0.017) were in the ES-free group. Kaplan-Meier estimates and a log-rank test showed that patients with nonischemic dilated cardiomyopathy (DCMP) (log-rank test, p = 0.016) or with left ventricular ejection fraction < 35% (p = 0.032) were more likely to experience ES, and that patients with VF (p = 0.047) were less affected by ES. Cox proportional hazard regression analysis showed that nonischemic DCMP correlated with a greater probability of ES (hazard ratio, 3.71; 95% confidence interval, 1.16-11.85; p = 0.027).
ES is a common and recurrent event in patients with an ICD. Nonischemic DCMP is an independent predictor of ES. Patients with VF or with a structurally normal heart are less likely to experience ES. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 G704-000409.2011.52.1.023 http://kmbase.medric.or.kr/Main.aspx?d=KMBASE&m=VIEW&i=0311120110520010026 |
ISSN: | 0513-5796 1976-2437 |
DOI: | 10.3349/ymj.2011.52.1.26 |