One-year outcomes in cardiogenic shock triggered by supraventricular tachycardia: an analysis of the FRENSHOCK multicenter prospective registry

Abstract

Abstract Background Cardiogenic shock (CS) is the most severe form of heart failure (HF), resulting in high early and long-term mortality. Characteristics of CS secondary to supraventricular tachycardia (SVT) are poorly reported. Based on a large registry of unselected CS, our aim was to compare one-year outcomes between SVT-triggered and non-SVT-triggered CS. Methods FRENSHOCK is a prospective registry including 772 CS from 49 centers. One to three triggers could be identified (ischemic, mechanical complications, ventricular/supraventricular arrhythmia, bradycardia, iatrogenesis, infection, non-compliance, others). One-year outcomes (rehospitalizations, mortality, heart transplantation (HTx), ventricular assist devices (VAD)) were analyzed, adjusted on independent predictive factors. Results Within 769 CS included, 100 were SVT-triggered (13%) with 65 with SVT as exclusive trigger (8.5%). SVT triggered CS patients were more male with more frequent history of cardiomyopathy or chronic kidney disease, and more profound CS (biventricular failure and multiorgan failure). At 1-year, there was no difference in all-cause mortality (HR 0.91 [0.66 – 1.26], p = 0.58), need for HTx or VAD (OR 0.88 [0.41 – 1.88], p = 0.74) or rehospitalizations (OR 1.24 [0.78 – 1.98], p = 0.36). Patients with SVT as exclusive trigger presented more 1-year rehospitalizations (OR 3.74 [1.05 – 10.5], p = 0.01). Conclusion SVT is a frequent trigger of CS alone or in association in more than 10% of miscellaneous CS. Although SVT-triggered CS patients were more comorbid with more pre-existing cardiomyopathies and HF, they presented similar rates of mortality, HTx and VAD at 1-year arguing for a better overall prognosis.Graphical abstract