Electrical storms in patients with implantable cardioverter-defibrillator: incidence and clinical management

• Published in: Giornale italiano di cardiologia (2006) Vol. 7; no. 10; p. 695
• Main Authors: Devecchi, Paolo, Plebani, Laura, Occhetta, Eraldo, Bortnik, Miriam, Francalacci, Gabriella, Magnani, Andrea, Marino, Paolo
• Format: Journal Article
• Language: Italian
• Published: Italy 01.10.2006
• Subjects: Aged; Defibrillators, Implantable - adverse effects; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Tachycardia, Ventricular - epidemiology; Tachycardia, Ventricular - etiology; Tachycardia, Ventricular - therapy; Ventricular Fibrillation - epidemiology; Ventricular Fibrillation - etiology; Ventricular Fibrillation - therapy
• ISSN: 1827-6806

Electrical storm in implantable cardioverter-defibrillator (ICD) recipients is a dramatic experience for the patient and a hard emergency for the cardiology team. The aim of our study was to evaluate the incidence and the clinical significance of electrical storm in a standard population of ICD patients. We considered retrospectively 262 consecutive ICD patients (86% males, mean age 65+/-10.7 years). Patients were divided into three groups: 88 patients without appropriate ICD therapy (group A); 140 patients with isolated ICD therapies (group B); 34 patients with electrical storm episodes (> or = 3 appropriate ICD therapies/24 h) (group C). Survival study (endpoint death) was performed for each group of patients. There was no difference in age, sex, heart disease, ejection fraction or NYHA functional class among the three groups. ICD implant was performed for secondary prevention in 79% of group C patients and in 74.3 % of group B patients, but only in 39.8 % of group A patients (p < 0.0001). Mean follow-up was 31.1+/-29.8 months in group A, 55.1+/-38 months in group B, and 71.1+/-51.7 months in group C. The endpoint was reached by 16 patients (18%) of group A, by 53 patients (38%) of group B, and by 20 patients (58%) of group C. Comparison of the survival curves of the three groups did not show significant differences. In group C patients, 54 electrical storm episodes were recorded (mean 1.5/patient). In our population of ICD patients, we observed electrical storm in 34 patients (12.9%). Survival in group with episodes of electrical storm was comparable to patients without electrical storm; thus, in our experience, electrical storm could not represent a negative prognostic factor.