Electrical storm is associated with impaired prognosis compared to ventricular tachyarrhythmias
Electrical storm is associated with impaired prognosis compared to ventricular tachyarrhythmias
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DOI：
10.1016/j.ijcard.2019.04.034
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发表时间：
2019-10-01
影响因子：
3.5
通讯作者：
Akin, Ibrahim
中科院分区：
文献类型：
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作者：
Behnes, Michael;Mueller, Julian;Akin, Ibrahim
背景：由于电风暴（ES）的数据有限，本研究旨在比较ES患者与室性心动过速患者在死亡率、再住院率和主要心脏不良事件（MACE）方面的预后。方法：在这项回顾性研究中，将连续植入式心律转复除颤器（ICD）接受者与幸存的室性心动过速(室性心动过速（VT）或纤颤（VF）患者进行比较；非es)，于2002年至2016年期间入学。主要终点是全因死亡率，次要终点是随访2.5年的再住院和MACE。结果：连续纳入764例ICD患者（11%为ES， 89%为VTA）。ES与较高的全因死亡率相关（37% vs. 20%, log-rank p = 0.001; HR 2.084; 95% CI 1.416-3.065, p = 0.001）。然而，仅在二级预防性ICD受者中，ES与死亡率仍然显著相关（39% vs. 20%; log rank p = 0.001; HR 2.235, 95% CI 1.378-3.625, p = 0.001）。此外，ES与较高的再住院率相关（44%对12%，log-rank p = 0.001; HR 4.763, 95% CI 3.237-7.009, p = 0.001），主要是由于VT（22%对4%，p = 0.001）和急性心力衰竭（AHF）（17%对4%，p = 0.001）和较高的MACE发生率（40%对23%，log rank p = 0.001; HR 1.838; 95% CI 1.283 -2.654, p = 0.002）。即使在多变量调整后，仍然观察到死亡和再住院的风险增加。结论：与非ES的室性心动过速患者相比，ES与全因死亡率、VT和AHF再住院率以及2.5年时的MACE相关。(C) 2019 Elsevier B.V.版权所有
Background: Because data on electrical storm (ES) is limited, this study sought to compare the prognosis of patients with ES to those with ventricular tachyarrhythmias on mortality, rehospitalization and major adverse cardiac events (MACE).Methods: In this retrospective study consecutive implantable cardioverter defibrillator (ICD) recipients presenting with ES were compared to patients surviving ventricular tachyarrhythmias (ventricular tachycardia (VT) or fibrillation (VF); non-ES) on admission from 2002 to 2016. The primary endpoint was all-cause mortality, secondary endpoints were rehospitalization and MACE at 2.5 years of follow-up.Results: 764 consecutive patients with an ICD were included (11% with ES, 89% with VTA). ES was associated with higher rates of all-cause mortality (37% vs. 20%, log-rank p = 0.001; HR 2.084; 95% CI 1.416-3.065, p = 0.001). However, only in secondary preventive ICD recipients, ES remained significantly associated with mortality (39% vs. 20%; log rank p = 0.001; HR 2.235, 95% CI 1.378-3.625, p = 0.001). Furthermore, ES was associated with higher rates of rehospitalization (44% vs. 12%, log-rank p = 0.001; HR 4.763, 95% CI 3.237-7.009, p = 0.001), mainly due to VT (22% vs. 4%, p = 0.001) and acute heart failure (AHF) (17% vs. 4%, p = 0.001) and higher rates of MACE (40% vs. 23%; log rank p = 0.001; HR 1.838; 95% CI 1.273-2.654, p = 0.002). Increasing risks of death and rehospitalization were still observed even after multivariable adjustment.Conclusion: ES was associated with increased rates of all-cause mortality, rehospitalization, respectively due to VT and AHF, as well as MACE at 2.5 years compared to patients with ventricular tachyarrhythmias apart from ES. (C) 2019 Elsevier B.V. All rights reserved.