Catheter ablation of electrical storm in patients with structural heart disease
Electrical storm (ES) adversely affects prognosis of patients and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES. Fifty consecutive patients with...
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| Veröffentlicht in: | Europace (London, England) England), 2011-01, Vol.13 (1), p.109-113 |
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| creator | Kozeluhova, Marketa Peichl, Petr Cihak, Robert Wichterle, Dan Vancura, Vlastimil Bytesnik, Jan Kautzner, Josef |
| description | Electrical storm (ES) adversely affects prognosis of patients and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES.
Fifty consecutive patients with coronary artery disease (38), idiopathic dilated cardiomyopathy (5), arrhythmogenic right ventricular cardiomyopathy (6), and/or with combined aetiology (1) underwent CA for ES. Mean left ventricular ejection fraction (LVEF) was 29 ± 11%. All patients underwent electroanatomical mapping, and CA was performed to abolish all inducible ventricular arrhythmias. The ES was suppressed by CA in 84% of patients. During the follow-up of 18 ± 16 months, 24 patients had no recurrences of any ventricular tachycardia (VT; 48%). Repeated procedure was necessary to suppress the recurrent ES in 13 cases (26%). Statistical analysis revealed that low LVEF (22 ± 3 vs. 31 ± 12%; P < 0.001), increased LVend-diastolic diameter (72 ± 9.1 vs. 64 ± 8.9 mm; P = 0.0135), and renal insufficiency (P < 0.001) were the univariate predictors of early mortality or necessity for heart transplantation. Recurrence of ES despite previous CA procedure was associated with a higher risk of death or heart transplant during follow-up (P < 0.05).
Catheter ablation is effective in acute suppression of ES and often represents a life-saving therapy. In the long term, it prevents recurrences of any VT in about half of the treated patients. |
| doi_str_mv | 10.1093/europace/euq364 |
| format | Article |
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Fifty consecutive patients with coronary artery disease (38), idiopathic dilated cardiomyopathy (5), arrhythmogenic right ventricular cardiomyopathy (6), and/or with combined aetiology (1) underwent CA for ES. Mean left ventricular ejection fraction (LVEF) was 29 ± 11%. All patients underwent electroanatomical mapping, and CA was performed to abolish all inducible ventricular arrhythmias. The ES was suppressed by CA in 84% of patients. During the follow-up of 18 ± 16 months, 24 patients had no recurrences of any ventricular tachycardia (VT; 48%). Repeated procedure was necessary to suppress the recurrent ES in 13 cases (26%). Statistical analysis revealed that low LVEF (22 ± 3 vs. 31 ± 12%; P < 0.001), increased LVend-diastolic diameter (72 ± 9.1 vs. 64 ± 8.9 mm; P = 0.0135), and renal insufficiency (P < 0.001) were the univariate predictors of early mortality or necessity for heart transplantation. Recurrence of ES despite previous CA procedure was associated with a higher risk of death or heart transplant during follow-up (P < 0.05).
Catheter ablation is effective in acute suppression of ES and often represents a life-saving therapy. In the long term, it prevents recurrences of any VT in about half of the treated patients.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euq364</identifier><identifier>PMID: 20947570</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Arrhythmias, Cardiac - complications ; Arrhythmias, Cardiac - epidemiology ; Cardiomyopathy, Dilated - complications ; Cardiomyopathy, Dilated - epidemiology ; Catheter Ablation ; Comorbidity ; Coronary Artery Disease - complications ; Coronary Artery Disease - epidemiology ; Female ; Follow-Up Studies ; Heart Diseases - complications ; Heart Diseases - epidemiology ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Retrospective Studies ; Tachycardia, Ventricular - epidemiology ; Tachycardia, Ventricular - mortality ; Tachycardia, Ventricular - surgery ; Treatment Outcome ; Ventricular Fibrillation - epidemiology ; Ventricular Fibrillation - mortality ; Ventricular Fibrillation - surgery</subject><ispartof>Europace (London, England), 2011-01, Vol.13 (1), p.109-113</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-148a81d5e61d3abcca4f6ad466dc30f0b0edd4cad7406a47a10bfde7f75d6d253</citedby><cites>FETCH-LOGICAL-c337t-148a81d5e61d3abcca4f6ad466dc30f0b0edd4cad7406a47a10bfde7f75d6d253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20947570$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kozeluhova, Marketa</creatorcontrib><creatorcontrib>Peichl, Petr</creatorcontrib><creatorcontrib>Cihak, Robert</creatorcontrib><creatorcontrib>Wichterle, Dan</creatorcontrib><creatorcontrib>Vancura, Vlastimil</creatorcontrib><creatorcontrib>Bytesnik, Jan</creatorcontrib><creatorcontrib>Kautzner, Josef</creatorcontrib><title>Catheter ablation of electrical storm in patients with structural heart disease</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>Electrical storm (ES) adversely affects prognosis of patients and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES.
Fifty consecutive patients with coronary artery disease (38), idiopathic dilated cardiomyopathy (5), arrhythmogenic right ventricular cardiomyopathy (6), and/or with combined aetiology (1) underwent CA for ES. Mean left ventricular ejection fraction (LVEF) was 29 ± 11%. All patients underwent electroanatomical mapping, and CA was performed to abolish all inducible ventricular arrhythmias. The ES was suppressed by CA in 84% of patients. During the follow-up of 18 ± 16 months, 24 patients had no recurrences of any ventricular tachycardia (VT; 48%). Repeated procedure was necessary to suppress the recurrent ES in 13 cases (26%). Statistical analysis revealed that low LVEF (22 ± 3 vs. 31 ± 12%; P < 0.001), increased LVend-diastolic diameter (72 ± 9.1 vs. 64 ± 8.9 mm; P = 0.0135), and renal insufficiency (P < 0.001) were the univariate predictors of early mortality or necessity for heart transplantation. Recurrence of ES despite previous CA procedure was associated with a higher risk of death or heart transplant during follow-up (P < 0.05).
Catheter ablation is effective in acute suppression of ES and often represents a life-saving therapy. In the long term, it prevents recurrences of any VT in about half of the treated patients.</description><subject>Aged</subject><subject>Arrhythmias, Cardiac - complications</subject><subject>Arrhythmias, Cardiac - epidemiology</subject><subject>Cardiomyopathy, Dilated - complications</subject><subject>Cardiomyopathy, Dilated - epidemiology</subject><subject>Catheter Ablation</subject><subject>Comorbidity</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Diseases - complications</subject><subject>Heart Diseases - epidemiology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Tachycardia, Ventricular - epidemiology</subject><subject>Tachycardia, Ventricular - mortality</subject><subject>Tachycardia, Ventricular - surgery</subject><subject>Treatment Outcome</subject><subject>Ventricular Fibrillation - epidemiology</subject><subject>Ventricular Fibrillation - mortality</subject><subject>Ventricular Fibrillation - surgery</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAQhi0EoqUwsyFvTKH-it2MqKKAVKkLzNHFvqhB-artCPHvMWrLdK_ufe6Gh5B7zp44K-QSJz-MYDGFg9Tqgsx5LkUmWCEuU2ZFkeVcFDNyE8IXY8yIIr8ms9Qrkxs2J7s1xD1G9BSqFmIz9HSoKbZoo28stDTEwXe06emYWuxjoN9N3Ke1n2ycfCL2CD5S1wSEgLfkqoY24N1pLsjn5uVj_ZZtd6_v6-dtZqU0MeNqBSvuctTcSaisBVVrcEprZyWrWcXQOWXBGcU0KAOcVbVDU5vcaSdyuSCPx7-jHw4Thlh2TbDYttDjMIVyJTgvuBQ6kcsjaf0Qgse6HH3Tgf8pOSv_JJZnieVRYrp4OP2eqg7dP3-2Jn8BqUlyoQ</recordid><startdate>201101</startdate><enddate>201101</enddate><creator>Kozeluhova, Marketa</creator><creator>Peichl, Petr</creator><creator>Cihak, Robert</creator><creator>Wichterle, Dan</creator><creator>Vancura, Vlastimil</creator><creator>Bytesnik, Jan</creator><creator>Kautzner, Josef</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201101</creationdate><title>Catheter ablation of electrical storm in patients with structural heart disease</title><author>Kozeluhova, Marketa ; Peichl, Petr ; Cihak, Robert ; Wichterle, Dan ; Vancura, Vlastimil ; Bytesnik, Jan ; Kautzner, Josef</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-148a81d5e61d3abcca4f6ad466dc30f0b0edd4cad7406a47a10bfde7f75d6d253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Arrhythmias, Cardiac - complications</topic><topic>Arrhythmias, Cardiac - epidemiology</topic><topic>Cardiomyopathy, Dilated - complications</topic><topic>Cardiomyopathy, Dilated - epidemiology</topic><topic>Catheter Ablation</topic><topic>Comorbidity</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Diseases - complications</topic><topic>Heart Diseases - epidemiology</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Tachycardia, Ventricular - epidemiology</topic><topic>Tachycardia, Ventricular - mortality</topic><topic>Tachycardia, Ventricular - surgery</topic><topic>Treatment Outcome</topic><topic>Ventricular Fibrillation - epidemiology</topic><topic>Ventricular Fibrillation - mortality</topic><topic>Ventricular Fibrillation - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kozeluhova, Marketa</creatorcontrib><creatorcontrib>Peichl, Petr</creatorcontrib><creatorcontrib>Cihak, Robert</creatorcontrib><creatorcontrib>Wichterle, Dan</creatorcontrib><creatorcontrib>Vancura, Vlastimil</creatorcontrib><creatorcontrib>Bytesnik, Jan</creatorcontrib><creatorcontrib>Kautzner, Josef</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kozeluhova, Marketa</au><au>Peichl, Petr</au><au>Cihak, Robert</au><au>Wichterle, Dan</au><au>Vancura, Vlastimil</au><au>Bytesnik, Jan</au><au>Kautzner, Josef</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Catheter ablation of electrical storm in patients with structural heart disease</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2011-01</date><risdate>2011</risdate><volume>13</volume><issue>1</issue><spage>109</spage><epage>113</epage><pages>109-113</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>Electrical storm (ES) adversely affects prognosis of patients and may become a life-threatening event. Catheter ablation (CA) has been proposed for the treatment of ES. Our goal was to evaluate the efficacy of CA ablation both in acute and long-term suppression of ES.
Fifty consecutive patients with coronary artery disease (38), idiopathic dilated cardiomyopathy (5), arrhythmogenic right ventricular cardiomyopathy (6), and/or with combined aetiology (1) underwent CA for ES. Mean left ventricular ejection fraction (LVEF) was 29 ± 11%. All patients underwent electroanatomical mapping, and CA was performed to abolish all inducible ventricular arrhythmias. The ES was suppressed by CA in 84% of patients. During the follow-up of 18 ± 16 months, 24 patients had no recurrences of any ventricular tachycardia (VT; 48%). Repeated procedure was necessary to suppress the recurrent ES in 13 cases (26%). Statistical analysis revealed that low LVEF (22 ± 3 vs. 31 ± 12%; P < 0.001), increased LVend-diastolic diameter (72 ± 9.1 vs. 64 ± 8.9 mm; P = 0.0135), and renal insufficiency (P < 0.001) were the univariate predictors of early mortality or necessity for heart transplantation. Recurrence of ES despite previous CA procedure was associated with a higher risk of death or heart transplant during follow-up (P < 0.05).
Catheter ablation is effective in acute suppression of ES and often represents a life-saving therapy. In the long term, it prevents recurrences of any VT in about half of the treated patients.</abstract><cop>England</cop><pmid>20947570</pmid><doi>10.1093/europace/euq364</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - epidemiology Cardiomyopathy, Dilated - complications Cardiomyopathy, Dilated - epidemiology Catheter Ablation Comorbidity Coronary Artery Disease - complications Coronary Artery Disease - epidemiology Female Follow-Up Studies Heart Diseases - complications Heart Diseases - epidemiology Humans Kaplan-Meier Estimate Male Middle Aged Retrospective Studies Tachycardia, Ventricular - epidemiology Tachycardia, Ventricular - mortality Tachycardia, Ventricular - surgery Treatment Outcome Ventricular Fibrillation - epidemiology Ventricular Fibrillation - mortality Ventricular Fibrillation - surgery |
| title | Catheter ablation of electrical storm in patients with structural heart disease |
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