Electrical storm in patients with prophylactic defibrillator implantation
Por:
Rodríguez-Mañero M, González-Cambeiro C, Moreno-Arribas J, Expósito-García V, Sánchez-Gómez JM, González-Torres L, Arce-León Á, Arguedas-Jiménez H, Gaztañaga L, Salvador-Montañés O, Iglesias-Bravo JA, Huerta AA, Fernández-Armenta J, Arias MÁ and Martínez-Sande L
Publicada:
1 ene 2016
Categoría:
Cardiology and cardiovascular medicine
Resumen:
Introduction: Little is known about the prevalence of electrical storm, baseline characteristics and mortality implications of patients with implantable cardioverter defibrillator in primary prevention versus those patients without electrical storm. We sought to assess the prevalence, baseline risk profile and survival significance of electrical storm in patients with implantable defibrillator for primary prevention.
Methods: Retrospective multicenter study performed in 15 Spanish hospitals. Consecutives patients referred for desfibrillator implantation, with or without left ventricular lead (at least those performed in 2010 and 2011), were included.
Results: Over all 1,174 patients, 34 (2,9%) presented an electrical storm, mainly due to ventricular tachycardia (82.4%). There were no significant baseline differences between groups, with similar punctuation in the mortality risk scores (SHOCKED, MADIT and FADES). A clear trigger was identified in 47% of the events. During the study period (38 +/- 21 months), long-term total mortality (58.8% versus 14.4%, p < 0.001) and cardiac mortality (52.9% versus 8.6%, p < 0.001) were both increased among electrical storm patients. Rate of inappropriate desfibrillator intervention was also higher (14.7 versus 8.6%, p < 0.001).
Conclusions: In the present study of patients with desfibrillator implantation for primary prevention, prevalence of electrical storm was 2.9%. There were no baseline differences in the cardiovascular risk profile versus those without electrical storm. However, all cause mortality and cardiovascular mortality was increased in these patients versus control desfibrillator patients without electrical storm, as was the rate of inappropriate desfibrillator intervention. (C) 2015 Instituto Nacional de Cardiologia Ignacio Chavez. Published by Masson Doyma Mexico S.A. All rights reserved.
Filiaciones:
Rodríguez-Mañero M:
Servicio de Cardiología, Hospital Universitario Santiago de Compostela, España.
González-Cambeiro C:
Servicio de Cardiología, Hospital Universitario Santiago de Compostela, España
:
Servicio de Cardiología, Hospital Universitario San Juan, Alicante, España
Expósito-García V:
Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, España
Sánchez-Gómez JM:
Servicio de Cardiología, Hospital Clínico Universitario de Valencia, España
González-Torres L:
Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla, España
Arce-León Á:
Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, España
Arguedas-Jiménez H:
Servicio de Cardiología, Clínica Universidad de Navarra, Pamplona, España
Gaztañaga L:
Servicio de Cardiología, Hospital de Basurto, Bilbao, España
Salvador-Montañés O:
Servicio de Cardiología Hospital Universitario La Paz, Madrid, España
Iglesias-Bravo JA:
Servicio de Cardiología, Hospital Fundación Jiménez Díaz, Madrid, España
Huerta AA:
Servicio de Cardiología, Hospital Universitario La Fe, Valencia, España
Fernández-Armenta J:
Servicio de Cardiología, Hospital Puerta del Mar, Cádiz, España
Arias MÁ:
Servicio de Cardiología, Hospitalario Virgen de la Salud, Toledo, España
Martínez-Sande L:
Servicio de Cardiología, Hospital Universitario Santiago de Compostela, España
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