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Significant impact of electrical storm on mortality in patients with structural heart disease and an implantable cardiac defibrillator
- Source :
- International Journal of Cardiology. 255:85-91
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- 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 28months (interquartile range: 23 to 33months), 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.
- Subjects :
- Male
medicine.medical_specialty
Heart disease
Defibrillation
animal diseases
medicine.medical_treatment
030204 cardiovascular system & hematology
Article
Sudden cardiac death
Cardiac Resynchronization Therapy
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
medicine
Humans
Prospective Studies
Registries
cardiovascular diseases
030212 general & internal medicine
Mortality
Survival analysis
Aged
business.industry
Incidence (epidemiology)
Cardiac Resynchronization Therapy Devices
Dilated cardiomyopathy
Middle Aged
medicine.disease
Defibrillators, Implantable
Ventricular Fibrillation
cardiovascular system
Cardiology
Female
Cardiomyopathies
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 255
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....a8dc5d93475ed2f8f65950b26754cea3