Abstract 8858: Reduced Left Ventricular Ejection Fraction is Associated with Higher Long-Term Mortality in Patients with Electrical Storm

Abstract

Introduction: Little is known about the relationship between LV ejection fraction (EF) and mortality in contemporary patients with electrical storm (ES). Objective: EF at the time of admission for ES was organized into subgroups: EF ≤ 22% (A), 23-32% (B), 33-42% (C), 43-52% (D), and >52% (E). EF subgroups were compared to determine differences in 1-year all-cause mortality. Secondary outcomes included cardiogenic shock (CS), multiorgan system failure, acute tubular necrosis (ATN), and cardiac arrest. We hypothesize that patients with reduced EF will have poorer short-term prognosis and more in-hospital complications. Methods: Single center, retrospective study including consecutive patients admitted to the coronary ICU with ES between April 2014 - 2020. ES was defined as ≥ 3 isolated sustained ventricular arrhythmias or ICD therapies within 24 hours. Results: Of 214 patients admitted with ES, 203 had an echocardiogram on admission. 70 (34.5%) were group A, 58 (28.6%) group B, 36 (17.7%) group C, 23 (11.3%) group D, and 16 (7.9%) group E. The mean EF was 30 +/- 13% (Figure 1). The mean age was 64 +/- 13 years, 83.3% male. 1-year all-cause mortality between subgroups was significant by Kaplan-Meier survival estimate and Mantel-Cox log rank (χ 2 11.2; p 0.023; Figure 2). By Cox Regression using Group E as a reference, only Group A had a statistically significant difference in 1-year all-cause mortality (HR A/E 3.71 [95% CI 1.14 - 12.07]; p 0.029). Analysis of in-hospital complications showed a difference only in cardiogenic shock (p < 0.0001) with higher incidence in those with lower EF (Figure 3). Conclusions: In patients with ES, LVEF is significantly associated with all-cause 1-year mortality. Those with significantly impaired LVEF (≤ 22%) had higher 1-year all-cause mortality compared to those with preserved EF (> 52%).