Effect of cardiac resynchronization therapy on the incidence of electrical storm
| Autor: | Peter Nordbeck, Oliver Ritter, Wolfgang R. Bauer, Bernhard Seidl, Beatrix Fey |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Tachycardia medicine.medical_specialty Heart disease animal diseases medicine.medical_treatment Cardiac resynchronization therapy Ventricular tachycardia Cardiac Resynchronization Therapy Risk Factors Internal medicine medicine Humans cardiovascular diseases Aged Retrospective Studies Heart Failure Fibrillation Ejection fraction business.industry Incidence Middle Aged Prognosis medicine.disease Survival Analysis Heart failure Ventricular Fibrillation Ventricular fibrillation Tachycardia Ventricular cardiovascular system Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 143:330-336 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2009.03.055 |
| Popis: | Hemodynamic improvement from biventricular pacing is well documented; however, its electrophysiologic effects have not been systematically studied. In this study, incidence and risk factors for electrical storm (ES) were investigated in 729 ICD and biventricular defibrillator (CRT-D) heart failure patients.168 consecutive CRT-D and 561 ICD patients were retrospectively analyzed for the occurrence of VT/VF and predisposing factors. Electrical storm was defined as ventricular tachycardia or fibrillation ≥3 times during 24 h. Mean follow-up was 41 months.In 168 CRT-D patients only one patient experienced electrical storm compared to 39 patients out of 561 ICD patients (0.6% vs. 7%, p0.01). 33% of the patients with electrical storm died within one year. In the CRT-D group 81 patients (48%) developed VT or VF and received at least one appropriate therapy, compared to 281 patients (50%) in the ICD group. Mean ejection fraction was 21.7% in the CRT-D group and 34.7% (p0.01) in the ICD group. Stratifying the patients according to primary or secondary prevention and ejection fraction demonstrated that VT/VF clusters were significantly associated with ICD indication for secondary prevention, previous myocardial infarction and LVEF30%.The development of electrical storm is accompanied with a highly increased mortality risk even if an ICD/CRT-D is implanted. In CRT-D patients electrical storm is much less common than in ICD patients. Secondary prevention and ejection fraction30% are predictors of electrical storm. Beside hemodynamic improvements cardiac resynchronization therapy may reduce the arrhythmia burden in heart failure patients. |
| Databáze: | OpenAIRE |
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