Significant impact of electrical storm on mortality in patients with structural heart disease and an implantable cardiac defibrillator

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:255

Article

Noda, Takashi¹  Kurita, Takashi²  Nitta, Takashi³  Chiba, Yasutaka⁴  Furushima, Hiroshi⁵  Matsumoto, Naoki⁶  Toyoshima, Takeshi⁷  Shimizu, Akihiko⁸  Mitamura, Hideo⁹  Okumura, Ken¹⁰  Ohe, Tohru¹¹  Aizawa, Yoshifusa¹² 

[1] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Suita, Osaka, Japan

[2] Kindai Univ, Dept Internal Med, Fac Med, Osaka, Japan

[3] Nippon Med Sch, Dept Cardiovasc Surg, Tokyo, Japan

[4] Kindai Univ Hosp, Clin Res Ctr, Osaka, Japan

[5] Niigata Univ, Dept Internal Med 1, Sch Med, Niigata, Japan

[6] St Marianna Univ, Dept Pharmacol, Sch Med, Kawasaki, Kanagawa, Japan

[7] Saitama Med Univ, Fac Hlth & Med Care, Saitama, Japan

[8] Yamaguchi Univ, Fac Hlth Sci, Grad Sch Med, Ube, Yamaguchi, Japan

[9] Tachikawa Hosp, Cardiovasc Ctr, Tachikawa, Tokyo, Japan

[10] Saiseikai Kumamoto Hosp, Dept Cardiol, Kumamoto, Japan

[11] Okayama City Hosp, Okayama, Japan

[12] Tachikawa Med Ctr, Dept Res & Dev, Niigata, Japan

关键词: Cardiac resynchronization therapy device capable defibrillation (CRT-D);    Electrical storm;    Implantable cardioverter defibrillator (ICD);    Ventricular tachycardia;    Ventricular fibrillation;   

DOI  :  10.1016/j.ijcard.2017.11.077

来源: Elsevier

【 摘 要 】

Background: Electrical storm (E-Storm), defined as multiple episodes of ventricular arrhythmias within a short period of time, is an important clinical problem in patients with an implantable cardiac defibrillator (ICD) including cardiac resynchronization therapy devices capable of defibrillation. The detailed clinical aspects of E-Storm in large populations especially for non-ischemic dilated cardiomyopathy (DCM), however, remain unclear. Objective: This study was performed to elucidate the detailed clinical aspects of E-Storm, such as its predictors and prevalence among patients with structural heart disease including DCM. Methods: We analyzed the data of the Nippon Storm Study, which was a prospective observational study involving 1570 patients enrolled from 48 ICD centers. For the purpose of this study, we evaluated 1274 patients with structural heart disease, including 482 (38%) patients with ischemic heart disease (IHD) and 342 (27%) patients with DCM. Results: During a median follow-up of 28 months (interquartile range: 23 to 33 months), E-Storm occurred in 84 (6.6%) patients. The incidence of E-Storm was not significantly different between patients with IHD and patients with DCM (log-rank p = 0.52). Proportional hazard regression analyses showed that ICD implantation for secondary prevention of sudden cardiac death (p = 0.0001) and QRS width (p = 0.015) were the independent risk factors for E-storm. In a comparison between patients with and without E-Storm, survival curves after adjustment for clinical characteristics showed a significant difference in mortality. Conclusion: E-Storm was associated with subsequent mortality in patients with structural heart disease including DCM. (c) 2017 The Authors. Published by Elsevier Ireland Ltd.

【 授权许可】

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