Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support

Background The management of refractory electrical storm (ES) requiring mechanical circulation support (MCS) remains a clinical challenge in structural heart disease (SHD). Objective The study sought to explore the 30‐day and 1‐year outcome of rescue ablation for refractory ES requiring MCS in SHD. Methods A total of 81 patients (mean age: 55.3 ± 18.9, 73 men [90.1%]) undergoing ablation were investigated, including 26 patients with ES requiring MCS (group 1) and 55 patients without (group 2). The 30‐day and 1‐year outcome, including mortality and recurrent ventricular tachyarrhythmias (VAs) receiving appropriate implantable cardioverter defibrillators therapies, were assessed. Results The patients in group 1 were characterized by older age, more ischemic cardiomyopathies, worse left ventricular ejection fraction, and more comorbidities. Thirty days after ablation, overall events were seen in 15 patients (mortality in 10 and recurrent VA in 7), including pumping failure‐related mortality in 6 (60%). During a 30‐day follow‐up, higher mortality was noted in group 1. After a 1‐year follow‐up, in spite of the higher mortality in group 1 (P