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Electrical storm reveals worse prognosis compared to myocardial infarction complicated by ventricular tachyarrhythmias in ICD recipients

Both acute myocardial infarction complicated by ventricular tachyarrhythmias (AMI-VTA) and electrical storm (ES) represent life-threatening clinical conditions. However, a direct comparison of both sub-groups regarding prognostic endpoints has never been investigated. All consecutive implantable car...

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Main Authors: Müller, Julian (Author) , Behnes, Michael (Author) , Schupp, Tobias (Author) , Ellguth, Dominik (Author) , Taton, Gabriel (Author) , Reiser, Linda (Author) , Engelke, Niko (Author) , Borggrefe, Martin (Author) , Reichelt, Thomas (Author) , Kern-Bollow, Armin (Author) , El-Battrawy, Ibrahim (Author) , Weidner, Kathrin (Author) , Kim, Seung‑Hyun (Author) , Barth, Christian (Author) , Ansari, Uzair (Author) , Große Meininghaus, Dirk (Author) , Akın, Muharrem (Author) , Mashayekhi, Kambis (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: 26 April 2021
In: Heart and vessels
Year: 2021, Volume: 36, Issue: 11, Pages: 1701-1711
ISSN:1615-2573
DOI:10.1007/s00380-021-01844-9
Online Access:Resolving-System, kostenfrei, Volltext: https://doi.org/10.1007/s00380-021-01844-9
Verlag, kostenfrei, Volltext: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481166/
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Author Notes:Julian Müller, Michael Behnes, Tobias Schupp, Dominik Ellguth, Gabriel Taton, Linda Reiser, Niko Engelke, Martin Borggrefe, Thomas Reichelt, Armin Bollow, Ibrahim El-Battrawy, Kathrin Weidner, Seung-Hyun Kim, Christian Barth, Uzair Ansari, Dirk Große Meininghaus, Muharrem Akin, Kambis Mashayekhi, Ibrahim Akin
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Summary:Both acute myocardial infarction complicated by ventricular tachyarrhythmias (AMI-VTA) and electrical storm (ES) represent life-threatening clinical conditions. However, a direct comparison of both sub-groups regarding prognostic endpoints has never been investigated. All consecutive implantable cardioverter-defibrillator (ICD) recipients were included retrospectively from 2002 to 2016. Patients with ES apart from AMI (ES) were compared to patients with AMI accompanied by ventricular tachyarrhythmias (AMI-VTA). The primary endpoint was all-cause mortality at 3 years, secondary endpoints were in-hospital mortality, rehospitalization rates and major adverse cardiac event (MACE) at 3 years. A total of 198 consecutive ICD recipients were included (AMI-VTA: 56%; ST-segment elevation myocardial infarction (STEMI): 22%; non-ST-segment myocardial infarction (NSTEMI) 78%; ES: 44%). ES patients were older and had higher rates of severely reduced left ventricular ejection fraction (LVEF) < 35%. ES was associated with increased all-cause mortality at 3 years (37% vs. 19%; p = 0.001; hazard ratio [HR] = 2.242; 95% CI 2.291-3.894; p = 0.004) and with increased risk of first cardiac rehospitalization (44% vs. 12%; p = 0.001; HR = 4.694; 95% CI 2.498-8.823; p = 0.001). This worse prognosis of ES compared to AMI-VTA was still evident after multivariable adjustment (long-term all-cause mortality: HR = 2.504; 95% CI 1.093-5.739; p = 0.030; first cardiac rehospitalization: HR = 2.887; 95% CI 1.240-6.720; p = 0.014). In contrast, the rates of MACE (40% vs. 32%; p = 0.326) were comparable in both groups. At long-term follow-up of 3 years, ES was associated with higher rates of all-cause mortality and rehospitalization compared to patients with AMI-VTA.
Item Description:Gesehen am 04.01.2023
Physical Description:Online Resource
ISSN:1615-2573
DOI:10.1007/s00380-021-01844-9

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