B-PO02-122 LONG-TERM MORTALITY AND VENTRICULAR ARRHYTHMIA OUTCOMES IN ELECTRICAL STORM PATIENTS WHO UNDERGO ABLATION

Abstract

Data regarding long-term ablation outcomes in patients with electrical storm (ES) is limited. ES treated with ablation were compared to those who did not undergo ablation to determine differences in a composite of 1-year all-cause mortality and ventricular arrhythmia (VA) rehospitalization. Secondary outcomes include in-hospital all-cause and VA-induced mortality. 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 VA or ICD therapies within 24 hours. Of 214 patients admitted with ES, 79 underwent ablation. Overall demographics include mean age 64.2 +/- 13.2 years, 83.2% male, mean EF 30 +/- 13%, mean PAINESD score 17.5 +/- 6.2, and 82.7% had an ICD. 45 patients had a prior ablation. 20 (26.7%) ablations required mechanical circulatory support. The clinical VA was inducible in 84.8% of ablations and was successful in 73.4%, partially successful in 15.2%, and unsuccessful in 11.3%. ES treated with ablation had a lower composite 1-year all-cause mortality and VA readmission (39.24% vs. 64.44%; HR 0.50 [95% CI 0.33 - 0.76]; p 0.001; Figure 1) and 1-year all-cause mortality (29.11% vs. 48.89%; HR 0.51 [95% CI 0.32 - 0.82], p 0.005; Figure 2) compared to those who did not. 1-year VA recurrence (24.1% vs. 40.0%; p 0.059), in-hospital all-cause mortality (11.3% vs. 18.0%; p 0.18), and in-hospital VA-induced mortality (8.9% vs. 16.5%; p 0.11) were not statistically significant. ES patients treated with ablation had a 50% decreased risk of 1-year all-cause mortality and VA rehospitalization compared to those who were not ablated.