First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany.
First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany.
Int J Cardiol. 2019 Oct 1;292:119-125. doi: 10.1016/j.ijcard.2019.04.034. Epub 2019 Apr 12.
Because data on electrical storm (ES) is limited, this study sought to compare the prognosis of patients with ES to those with ventricular tachyarrhythmias on mortality, rehospitalization and major adverse cardiac events (MACE).
In this retrospective study consecutive implantable cardioverter defibrillator (ICD) recipients presenting with ES were compared to patients surviving ventricular tachyarrhythmias (ventricular tachycardia (VT) or fibrillation (VF); non-ES) on admission from 2002 to 2016. The primary endpoint was all-cause mortality, secondary endpoints were rehospitalization and MACE at 2.5 years of follow-up.
764 consecutive patients with an ICD were included (11% with ES, 89% with VTA). ES was associated with higher rates of all-cause mortality (37% vs. 20%, log-rank p = 0.001; HR 2.084; 95% CI 1.416-3.065, p = 0.001). However, only in secondary preventive ICD recipients, ES remained significantly associated with mortality (39% vs. 20%; log rank p = 0.001; HR 2.235, 95% CI 1.378-3.625, p = 0.001). Furthermore, ES was associated with higher rates of rehospitalization (44% vs. 12%, log-rank p = 0.001; HR 4.763, 95% CI 3.237-7.009, p = 0.001), mainly due to VT (22% vs. 4%, p = 0.001) and acute heart failure (AHF) (17% vs. 4%, p = 0.001) and higher rates of MACE (40% vs. 23%; log rank p = 0.001; HR 1.838; 95% CI 1.273-2.654, p = 0.002). Increasing risks of death and rehospitalization were still observed even after multivariable adjustment.
ES was associated with increased rates of all-cause mortality, rehospitalization, respectively due to VT and AHF, as well as MACE at 2.5 years compared to patients with ventricular tachyarrhythmias apart from ES.
由于关于电风暴（ES）的数据有限，本研究旨在比较 ES 患者与因室性心动过速心律失常（室性心动过速（VT）或颤动（VF）；非 ES）入院的患者的死亡率、再住院率和主要不良心脏事件（MACE）的预后。
在这项回顾性研究中，比较了 2002 年至 2016 年期间连续植入式心脏复律除颤器（ICD）患者的 ES 患者与存活的室性心动过速心律失常（VT 或 VF；非 ES）患者的预后。主要终点是全因死亡率，次要终点是 2.5 年随访时的再住院率和 MACE。
共纳入 764 例连续 ICD 患者（11%为 ES，89%为 VTA）。ES 与全因死亡率升高相关（37% vs. 20%，log-rank p=0.001；HR 2.084；95% CI 1.416-3.065，p=0.001）。然而，只有在二级预防 ICD 接受者中，ES 与死亡率仍显著相关（39% vs. 20%；log rank p=0.001；HR 2.235，95% CI 1.378-3.625，p=0.001）。此外，ES 与再住院率升高相关（44% vs. 12%，log-rank p=0.001；HR 4.763，95% CI 3.237-7.009，p=0.001），主要是由于 VT（22% vs. 4%，p=0.001）和急性心力衰竭（AHF）（17% vs. 4%，p=0.001），并且 MACE 发生率更高（40% vs. 23%；log rank p=0.001；HR 1.838；95% CI 1.273-2.654，p=0.002）。即使在多变量调整后，死亡和再住院的风险仍在增加。
与除 ES 以外的室性心动过速心律失常患者相比，ES 患者在 2.5 年内的全因死亡率、再住院率分别归因于 VT 和 AHF 以及 MACE 的发生率均较高。
