PO-04-192 RISK FACTORS AND OUTCOMES OF ELECTRICAL STORM AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION

Abstract

Electrical storm after Left Ventricular Assist Device (LVAD) is a recognized complication. The risk factors associated with electrical storm, impact on survival is less studied. The aim of this study is to study the incidence, risk factors of electrical storm after LVAD implantation and the impact of electrical storm on survival in patients undergoing LVAD. We performed a retrospective cohort study of all patients who underwent the LVAD implantation from January 1, 2001, to December 31, 2020, at the Mayo Clinic (Rochester, Phoenix, and Jacksonville). The incidence and outcomes of electrical storm (≥3 sustained [>30 seconds] ventricular arrhythmia episodes over a 24-hour period) were identified. Among 886 patients who underwent LVAD implantation, electrical storm occurred in 61 (7%) patients after median of 13 days (interquartile range [IQR] 4.5- 302) post LVAD implantation. Thirty-five patients (57.3%) developed electrical storm within 30 days, while 26 patients (42.6%) developed ES at a median of 689 days (IQR of 228-1171) after LVAD. Pre LVAD history of ventricular arrhythmias (43% vs 25%, p-value=0.002) and implantable cardioverter-defibrillator (ICD) shock (34% vs 22%, p-value=0.024) and history of were significantly associated with electrical storm after LVAD implantation. The 1-year mortality rate after first occurrence of electrical storm was 38%. Following LVAD implantation, the rate of electrical storm was 7% with majority of electrical storm occurring within 30-days of LVAD. Risk factors for electrical storm included pre-implant history of ventricular arrhythmias and ICD shock.