Catheter ablation of electrical storm in patients with structural heart disease.
Europace
; 13(1): 109-13, 2011 Jan.
Article
em En
| MEDLINE
| ID: mdl-20947570
ABSTRACT
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 ANDRESULTS:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Ventricular
/
Taquicardia Ventricular
/
Ablação por Cateter
/
Cardiopatias
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Europace
Assunto da revista:
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
República Tcheca