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

AbstractBoth 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 200 2 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 re...
Source: Heart and Vessels - Category: Cardiology Source Type: research