Τίτλος:
Electrical storm is an independent predictor of adverse long-term
outcome in the era of implantable defibrittator therapy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims Electrical storm (ES) is a life -threatening arrhythmia
complication affecting patients treated with an implantable cardioverter
defibrillator (ICD). Despite its increasing importance, existing data on
prognosis and management of ICD patients affected by ES are limited and
conflicting.
Methods We prospectively studied 169 consecutive patients receiving an
ICD. Thirty-two patients presented with at least one episode of ES
during the period of observation (33 +/- 26 months). ES patients were
older (64 +/- 9 vs. 59 +/- 13 years, P=0.013) with more advanced
congestive heart failure (CHF) but a similar incidence of an underlying
organic heart disease.
Results Long-term total and cardiac mortality were both increased among
ES patients. Seventeen of the 32 ES patients died as opposed to 19 of
the 137 ICD patients without ES (53 vs. 14%, P < 0.001). In
multivariate Cox regression analysis adjusted for the main confounders,
history of ES was significantly and independently associated with total
and cardiac mortality (risk ratio (RR)=2.13, P=0.031 and RR=2.59,
P=0.019, respectively).
Conclusion ES is a relatively frequent complication affecting ICD
patients treated for secondary prevention of sudden cardiac death (SCD).
Although the acute management of this serious arrhythmia complication is
usually successful, occurrence of ES is a strong independent predictor
of poor outcome in ICD patients. (c) 2005 The European Society of
Cardiology. Published by Elsevier Ltd. All rights reserved.
Συγγραφείς:
Gatzoulis, KA
Andrikopoulos, GK
Apostolopoulos, T and
Sotiropoulos, E
Zervopoulos, G
Antoniou, J
Brili, S and
Stefanadis, CI
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
electrical storm; implantable defibrillators; antiarrhythmic therapy
DOI:
10.1016/j.eupc.2005.01.003
