Abstract

Introduction: Electrical storm (ES) carries poor short- and long-term prognosis although there is limited evidence regarding outcomes of ES stratified by age. Objective: Primary outcomes include all-cause in-hospital and 1-year mortality of ES based on four age groups: < 55 years (1), age 55-64 (2), age 65-75 (3), and age < 75 years (4). We hypothesize that older patients (Groups 3, 4) will have worse short- and long-term mortality and higher rates of in-hospital complications. Methods: Single center, retrospective study including patients admitted to the coronary intensive care unit with ES between April 2014-2020. ES was defined as ≥ 3 isolated sustained ventricular arrhythmias (VA) or ICD therapies within 24 hours. Results: Of 214 patients admitted with ES, 44 (20.6%) were Group 1, 56 (26.2%) were Group 2, 70 (32.7%) were Group 3, and 44 (20.6%) were Group 4. The overall mean age was 64 ± 13 years. There was no significant difference between age groups regarding ejection fraction (p = 0.55) or prior history of VA (p = 0.48). There was a higher incidence of prior CAD (p = 0.0057) and worse PAINESD (p < 0.001) in the older groups. There was no significant difference in in-hospital complications between the four groups regarding multiorgan failure (p = 0.11), in-hospital cardiac arrest (p = 0.39), or cardiogenic shock (p = 0.27). There was no difference between the four groups in all-cause (20.5% vs. 12.5% vs. 12.9% vs. 20.5%; p = 0.51) or VA-induced in-hospital mortality (18.2% vs. 8.9% vs. 12.9% vs. 18.2%; p = 0.47). Using Group 1 as reference, only Group 4 had a significant difference in 365-day all-cause mortality (Figure 1; HR 1.94; 95% CI 1.0 - 3.8, p 0.049) but no difference in 365-day VT-free survival (Figure 2; p = 0.51). Conclusions: There is no difference in all-cause or VA-induced hospital mortality between age groups. There was a statistically significant increase in 365-day all-cause mortality between extremes of age, although there was no difference in 365-day VT-free survival.

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