Electrical Storms in Patients with an Implantable Cardioverter Defibrillator.
- Author:
Pil Sang SONG
1
;
June Soo KIM
;
Dae Hee SHIN
;
Jung Wae PARK
;
Ki In BAE
;
Chang Hee LEE
;
Dong Chae JUNG
;
Dong Ryeol RYU
;
Young Keun ON
Author Information
- Publication Type:Original Article
- Keywords: Implantable cardioverter defibrillators; ventricular tachycardia; ventricular fibrillation
- MeSH: Adult; Aged; Defibrillators, Implantable/*adverse effects; Female; Humans; Male; Middle Aged; Tachycardia, Ventricular/*diagnosis/etiology; Ventricular Fibrillation/*diagnosis/etiology
- From:Yonsei Medical Journal 2011;52(1):26-32
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: 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. MATERIALS AND METHODS: Eighty-five patients with an ICD were analyzed. ES was defined as the occurrence of two or more ventricular tachyarrhythmias within 24 hours. RESULTS: 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). CONCLUSION: 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.
