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....
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| Veröffentlicht in: | Journal of cardiovascular electrophysiology 2020-01, Vol.31 (1), p.9-17 |
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| creator | Chung, Fa‐Po Liao, Ying‐Chieh Lin, Yenn‐Jiang Chang, Shih‐Lin Lo, Li‐Wei Hu, Yu‐Feng Tuan, Ta‐Chuan Chao, Tze‐Fan Liao, Jo‐Nan Lin, Chin‐Yu Chang, Ting‐Yung Vicera, Jennifer Jeanne B. Chin, Chye‐Gen Wu, Cheng‐I Liu, Chih‐Min Lee, Po‐Tseng Huang, Ting‐Chun Lugtu, Isaiah C. Chen, Shih‐Ann |
| description | 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 |
| doi_str_mv | 10.1111/jce.14309 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2322740114</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2338889645</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-1c44ea821d5a2cbece5a1517bac8cff7c5241d9c5ff3b10d1212ecd0a9a9d983</originalsourceid><addsrcrecordid>eNp1kcFq3DAQhkVpSdJtDn2BIuglOTjRSNZaPpYlSVsCueRu5PG40WJbjmQ1LPThq91NeyhUF400Hx_D_Ix9BHEF-Vxvka6gVKJ-w85Al6IwsK7e5lqUulCmUqfsfYxbIUCthT5hpwqMMFLVZ-zXQ1rQj8R9zwNFTMRtO9jF-Ym7ic-5ommJ_MUtTxnog8XFhx3_mX-DwzTYwGkg3D_swGNujpl7Ti646QcfCZ_sdGihC3v8YI5pnn1YPrB3vR0inb_eK_Z4e_O4-VrcP9x923y5L1BpVReAZUnWSOi0ldgSkragoWotGuz7CrUsoatR971qQXQgQRJ2wta27mqjVuziqJ2Df04Ul2Z0EWkY7EQ-xUYqKatSQF7hin3-B936FKY8XKaUMaZelzpTl0cKg48xb6WZgxtt2DUgmn0iTU6kOSSS2U-vxtSO1P0l_0SQgesj8OIG2v3f1Hzf3ByVvwEhBJhk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2338889645</pqid></control><display><type>article</type><title>Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Chung, Fa‐Po ; Liao, Ying‐Chieh ; Lin, Yenn‐Jiang ; Chang, Shih‐Lin ; Lo, Li‐Wei ; Hu, Yu‐Feng ; Tuan, Ta‐Chuan ; Chao, Tze‐Fan ; Liao, Jo‐Nan ; Lin, Chin‐Yu ; Chang, Ting‐Yung ; Vicera, Jennifer Jeanne B. ; Chin, Chye‐Gen ; Wu, Cheng‐I ; Liu, Chih‐Min ; Lee, Po‐Tseng ; Huang, Ting‐Chun ; Lugtu, Isaiah C. ; Chen, Shih‐Ann</creator><creatorcontrib>Chung, Fa‐Po ; Liao, Ying‐Chieh ; Lin, Yenn‐Jiang ; Chang, Shih‐Lin ; Lo, Li‐Wei ; Hu, Yu‐Feng ; Tuan, Ta‐Chuan ; Chao, Tze‐Fan ; Liao, Jo‐Nan ; Lin, Chin‐Yu ; Chang, Ting‐Yung ; Vicera, Jennifer Jeanne B. ; Chin, Chye‐Gen ; Wu, Cheng‐I ; Liu, Chih‐Min ; Lee, Po‐Tseng ; Huang, Ting‐Chun ; Lugtu, Isaiah C. ; Chen, Shih‐Ann</creatorcontrib><description>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 < .001), the overall events and VA recurrences were similar between these two groups (P = .154 and P = .466, respectively). There was a significant reduction of VA burden in both groups and two patients had recurrent ES.
Conclusion
Higher 30‐day mortality was observed in patients undergoing rescue ablation for refractory ES requiring MCS, and pumping failure was the major cause of periprocedural death. Rescue ablation successfully prevented VA recurrences and resulted in a comparable 1‐year prognosis between ES with and without MCS.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.14309</identifier><identifier>PMID: 31808239</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Ablation ; Cardiovascular diseases ; Coronary artery disease ; Defibrillators ; electrical storm ; Heart diseases ; Ischemia ; mechanical circulation support ; Mortality ; pumping failure ; rescue ablation ; structural heart disease ; Ventricle</subject><ispartof>Journal of cardiovascular electrophysiology, 2020-01, Vol.31 (1), p.9-17</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><rights>2020 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-1c44ea821d5a2cbece5a1517bac8cff7c5241d9c5ff3b10d1212ecd0a9a9d983</citedby><cites>FETCH-LOGICAL-c3539-1c44ea821d5a2cbece5a1517bac8cff7c5241d9c5ff3b10d1212ecd0a9a9d983</cites><orcidid>0000-0001-6722-1826 ; 0000-0002-6397-0843 ; 0000-0003-3282-7523 ; 0000-0001-9102-227X ; 0000-0002-6587-3094 ; 0000-0001-9670-9708</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjce.14309$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjce.14309$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31808239$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chung, Fa‐Po</creatorcontrib><creatorcontrib>Liao, Ying‐Chieh</creatorcontrib><creatorcontrib>Lin, Yenn‐Jiang</creatorcontrib><creatorcontrib>Chang, Shih‐Lin</creatorcontrib><creatorcontrib>Lo, Li‐Wei</creatorcontrib><creatorcontrib>Hu, Yu‐Feng</creatorcontrib><creatorcontrib>Tuan, Ta‐Chuan</creatorcontrib><creatorcontrib>Chao, Tze‐Fan</creatorcontrib><creatorcontrib>Liao, Jo‐Nan</creatorcontrib><creatorcontrib>Lin, Chin‐Yu</creatorcontrib><creatorcontrib>Chang, Ting‐Yung</creatorcontrib><creatorcontrib>Vicera, Jennifer Jeanne B.</creatorcontrib><creatorcontrib>Chin, Chye‐Gen</creatorcontrib><creatorcontrib>Wu, Cheng‐I</creatorcontrib><creatorcontrib>Liu, Chih‐Min</creatorcontrib><creatorcontrib>Lee, Po‐Tseng</creatorcontrib><creatorcontrib>Huang, Ting‐Chun</creatorcontrib><creatorcontrib>Lugtu, Isaiah C.</creatorcontrib><creatorcontrib>Chen, Shih‐Ann</creatorcontrib><title>Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>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 < .001), the overall events and VA recurrences were similar between these two groups (P = .154 and P = .466, respectively). There was a significant reduction of VA burden in both groups and two patients had recurrent ES.
Conclusion
Higher 30‐day mortality was observed in patients undergoing rescue ablation for refractory ES requiring MCS, and pumping failure was the major cause of periprocedural death. Rescue ablation successfully prevented VA recurrences and resulted in a comparable 1‐year prognosis between ES with and without MCS.</description><subject>Ablation</subject><subject>Cardiovascular diseases</subject><subject>Coronary artery disease</subject><subject>Defibrillators</subject><subject>electrical storm</subject><subject>Heart diseases</subject><subject>Ischemia</subject><subject>mechanical circulation support</subject><subject>Mortality</subject><subject>pumping failure</subject><subject>rescue ablation</subject><subject>structural heart disease</subject><subject>Ventricle</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kcFq3DAQhkVpSdJtDn2BIuglOTjRSNZaPpYlSVsCueRu5PG40WJbjmQ1LPThq91NeyhUF400Hx_D_Ix9BHEF-Vxvka6gVKJ-w85Al6IwsK7e5lqUulCmUqfsfYxbIUCthT5hpwqMMFLVZ-zXQ1rQj8R9zwNFTMRtO9jF-Ym7ic-5ommJ_MUtTxnog8XFhx3_mX-DwzTYwGkg3D_swGNujpl7Ti646QcfCZ_sdGihC3v8YI5pnn1YPrB3vR0inb_eK_Z4e_O4-VrcP9x923y5L1BpVReAZUnWSOi0ldgSkragoWotGuz7CrUsoatR971qQXQgQRJ2wta27mqjVuziqJ2Df04Ul2Z0EWkY7EQ-xUYqKatSQF7hin3-B936FKY8XKaUMaZelzpTl0cKg48xb6WZgxtt2DUgmn0iTU6kOSSS2U-vxtSO1P0l_0SQgesj8OIG2v3f1Hzf3ByVvwEhBJhk</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Chung, Fa‐Po</creator><creator>Liao, Ying‐Chieh</creator><creator>Lin, Yenn‐Jiang</creator><creator>Chang, Shih‐Lin</creator><creator>Lo, Li‐Wei</creator><creator>Hu, Yu‐Feng</creator><creator>Tuan, Ta‐Chuan</creator><creator>Chao, Tze‐Fan</creator><creator>Liao, Jo‐Nan</creator><creator>Lin, Chin‐Yu</creator><creator>Chang, Ting‐Yung</creator><creator>Vicera, Jennifer Jeanne B.</creator><creator>Chin, Chye‐Gen</creator><creator>Wu, Cheng‐I</creator><creator>Liu, Chih‐Min</creator><creator>Lee, Po‐Tseng</creator><creator>Huang, Ting‐Chun</creator><creator>Lugtu, Isaiah C.</creator><creator>Chen, Shih‐Ann</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6722-1826</orcidid><orcidid>https://orcid.org/0000-0002-6397-0843</orcidid><orcidid>https://orcid.org/0000-0003-3282-7523</orcidid><orcidid>https://orcid.org/0000-0001-9102-227X</orcidid><orcidid>https://orcid.org/0000-0002-6587-3094</orcidid><orcidid>https://orcid.org/0000-0001-9670-9708</orcidid></search><sort><creationdate>202001</creationdate><title>Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support</title><author>Chung, Fa‐Po ; Liao, Ying‐Chieh ; Lin, Yenn‐Jiang ; Chang, Shih‐Lin ; Lo, Li‐Wei ; Hu, Yu‐Feng ; Tuan, Ta‐Chuan ; Chao, Tze‐Fan ; Liao, Jo‐Nan ; Lin, Chin‐Yu ; Chang, Ting‐Yung ; Vicera, Jennifer Jeanne B. ; Chin, Chye‐Gen ; Wu, Cheng‐I ; Liu, Chih‐Min ; Lee, Po‐Tseng ; Huang, Ting‐Chun ; Lugtu, Isaiah C. ; Chen, Shih‐Ann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-1c44ea821d5a2cbece5a1517bac8cff7c5241d9c5ff3b10d1212ecd0a9a9d983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ablation</topic><topic>Cardiovascular diseases</topic><topic>Coronary artery disease</topic><topic>Defibrillators</topic><topic>electrical storm</topic><topic>Heart diseases</topic><topic>Ischemia</topic><topic>mechanical circulation support</topic><topic>Mortality</topic><topic>pumping failure</topic><topic>rescue ablation</topic><topic>structural heart disease</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chung, Fa‐Po</creatorcontrib><creatorcontrib>Liao, Ying‐Chieh</creatorcontrib><creatorcontrib>Lin, Yenn‐Jiang</creatorcontrib><creatorcontrib>Chang, Shih‐Lin</creatorcontrib><creatorcontrib>Lo, Li‐Wei</creatorcontrib><creatorcontrib>Hu, Yu‐Feng</creatorcontrib><creatorcontrib>Tuan, Ta‐Chuan</creatorcontrib><creatorcontrib>Chao, Tze‐Fan</creatorcontrib><creatorcontrib>Liao, Jo‐Nan</creatorcontrib><creatorcontrib>Lin, Chin‐Yu</creatorcontrib><creatorcontrib>Chang, Ting‐Yung</creatorcontrib><creatorcontrib>Vicera, Jennifer Jeanne B.</creatorcontrib><creatorcontrib>Chin, Chye‐Gen</creatorcontrib><creatorcontrib>Wu, Cheng‐I</creatorcontrib><creatorcontrib>Liu, Chih‐Min</creatorcontrib><creatorcontrib>Lee, Po‐Tseng</creatorcontrib><creatorcontrib>Huang, Ting‐Chun</creatorcontrib><creatorcontrib>Lugtu, Isaiah C.</creatorcontrib><creatorcontrib>Chen, Shih‐Ann</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chung, Fa‐Po</au><au>Liao, Ying‐Chieh</au><au>Lin, Yenn‐Jiang</au><au>Chang, Shih‐Lin</au><au>Lo, Li‐Wei</au><au>Hu, Yu‐Feng</au><au>Tuan, Ta‐Chuan</au><au>Chao, Tze‐Fan</au><au>Liao, Jo‐Nan</au><au>Lin, Chin‐Yu</au><au>Chang, Ting‐Yung</au><au>Vicera, Jennifer Jeanne B.</au><au>Chin, Chye‐Gen</au><au>Wu, Cheng‐I</au><au>Liu, Chih‐Min</au><au>Lee, Po‐Tseng</au><au>Huang, Ting‐Chun</au><au>Lugtu, Isaiah C.</au><au>Chen, Shih‐Ann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2020-01</date><risdate>2020</risdate><volume>31</volume><issue>1</issue><spage>9</spage><epage>17</epage><pages>9-17</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>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 < .001), the overall events and VA recurrences were similar between these two groups (P = .154 and P = .466, respectively). There was a significant reduction of VA burden in both groups and two patients had recurrent ES.
Conclusion
Higher 30‐day mortality was observed in patients undergoing rescue ablation for refractory ES requiring MCS, and pumping failure was the major cause of periprocedural death. Rescue ablation successfully prevented VA recurrences and resulted in a comparable 1‐year prognosis between ES with and without MCS.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31808239</pmid><doi>10.1111/jce.14309</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6722-1826</orcidid><orcidid>https://orcid.org/0000-0002-6397-0843</orcidid><orcidid>https://orcid.org/0000-0003-3282-7523</orcidid><orcidid>https://orcid.org/0000-0001-9102-227X</orcidid><orcidid>https://orcid.org/0000-0002-6587-3094</orcidid><orcidid>https://orcid.org/0000-0001-9670-9708</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Ablation Cardiovascular diseases Coronary artery disease Defibrillators electrical storm Heart diseases Ischemia mechanical circulation support Mortality pumping failure rescue ablation structural heart disease Ventricle |
| title | Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support |
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