Abstract 15279: Ablation or Antiarrhythmic Drugs Alone in the Treatment of Ventricular Storm

Abstract

Introduction: Ventricular storms are managed with a combination of antiarrhythmic drugs (AAD) and ablation therapy. This study examines outcomes in patients who required cardiac intensive care unit (CICU) admission for ventricular storms. Methods: A retrospective cohort study was conducted of 200 random adult patients who admitted to the CICU at Mayo Clinic Rochester in 2016-2017 for ventricular storm. Continuous variables were analyzed with the Mann-Whitney U test. Categorical variables were analyzed with Fisher's exact test. Results: Of the 200 patients, 33 (16.5%) patients underwent ablation and AAD therapy for ventricular arrhythmias; 167 underwent AAD therapy alone. The patients in the ablation group were significantly younger (median of 60.3 vs. 72.7, U=1570, p<.001), had a lower Charlson Comorbidity Index (3.56 vs. 5.21, U=1916, p=.005), and a higher BMI (31.6 vs. 28.2, U=2028, p=.032). There was no difference in sex and race (white vs. non-white) between the two groups. The patients in the ablation groups had a significantly lower in-hospital mortality (0% vs. 20%, p=.001) and higher 1-year survival (91% vs. 63%, p=.001). There was no difference in length of stay in the CICU, length of stay in the hospital, or rate of hospital readmission within one year of discharge. Conclusions: Our study indicates that critically ill patients who undergo ablation and AAD for ventricular arrhythmias have decreased mortality compared to patients who underwent AAD therapy alone. More research is needed to elucidate whether this survival benefit is secondary to differences in treatment or baseline comorbidities in the two groups. Table 1: Characteristics and outcomes of patients undergoing ventricular storm treatment. Data is reported either as median or number of occurrences (%). Antiarrhythmic drug (AAD), Charlson Comorbidity Index (CCI), Body Mass Index (BMI), Cardiac Intensive Care Unit (CICU), Length of Stay in days (LOS). * Significance with p values < .05