Prognosis at one year after urgent catheter ablation for electrical storm in patients with scar-related left ventricular cardiomyopathy

Abstract

Listen

Translate article

Electrical storm (ES) is a severe event in patients with scar-related left ventricular cardiomyopathy. Prognosis factors of ventricular arrhythmias (VA) recurrence and death after catheter ablation (CA) are not clearly identified in this population. Aims of this study is to identify prognosis factor of VA recurrences and death at 30 days and one year after CA. Patients with scar-related left ventricular cardiomyopathy hospitalised for urgent CA for ES in four tertiary referral university hospitals (AP–HP, Paris) were retrospectively included. Patients’ characteristics, ES management and one-year follow-up were collected. In total, 124 patients with scar related left ventricular cardiomyopathy who underwent urgent CA for ES were included. Polymorphic VA (HR = 2.15 95% CI [1.16–3.97], P = 0.02) was independently associated with VA recurrences at 30 days. Dilated cardiomyopathy (DCM) was associated with VA recurrences (HR = 2.25 95% CI [1.31–3.87], P = 0.003) whereas beta-blockers at baseline were associated with less VA recurrences (HR = 0.46 95% CI [0.26–0.83], P = 0.01) at one year. PAINESD Score (HR = 1.09 95% CI [1.01–1.19], P = 0.04) and need for circulatory support (HR = 4.20 95% CI [1.81–9.75], P = 0.04) were associated with 30 day-mortality. PAINESD Score (HR = 1.10 95% CI [1.03–1.16], P = 0.003), DCM (HR = 3.52 95% CI [1.75–7.08], P < 0.0001) and circulatory support (HR = 3.55 95% CI [1.83–6.84], P < 0.0001) were associated with one year-mortality. At one year, 22% of patients who underwent cardiac graft and 50% with long-term LVAD died. Polymorphic VA is associated with VA recurrence at 30 days. PAINESD score was significantly associated with early and late mortality. Patients with DCM presented a higher risk of VA recurrence and death at one year.