We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Beyond the Storm: Comparison of Clinical Factors, Arrhythmogenic Substrate, and Catheter Ablation Outcomes in Structural Heart Disease Patients With versus Those Without a History of Ventricular Tachycardia Storm.
- Authors
KUMAR, SAURABH; FUJII, AKIRA; KAPUR, SUNIL; ROMERO, JORGE; MEHTA, NISHAKI K.; TANIGAWA, SHINICHI; EPSTEIN, LAURENCE M.; KOPLAN, BRUCE A.; MICHAUD, GREGORY F.; JOHN, ROY M.; STEVENSON, WILLIAM G.; TEDROW, USHA B.
- Abstract
Aims: Catheter ablation can be lifesaving in ventricular tachycardia (VT) storm, but the underlying substrate in patients with storm is not well characterized. We sought to compare the clinical factors, substrate, and outcomes differences in patients with sustained monomorphic VT who present for catheter ablation with VT storm versus those with a nonstorm presentation. Methods: Consecutive ischemic (ICM; n = 554) or nonischemic cardiomyopathy patients (NICM; n = 369) with a storm versus nonstorm presentation were studied (ICM storm 186; NICM storm 101). Results: In ICM, storm compared with nonstorm patients had significantly lower left ventricular (LV) ejection fraction (EF), greater number of antiarrhythmic drug (AAD) failures, slower VTs, greater number of scarred LV segments, higher incidence of anterior, septal, and apical endocardial LV scar (all P < 0.05). However, outcomes in follow-up were similar (12-month ventricular arrhythmia [VA]-free survival: 51% vs. 52%, P = 0.6; survival free of death/transplant 75% vs. 87%, P = 0.7). In addition to the above differences, NICM storm patients were also older; however, the extent and distribution of scar was similar except for a higher incidence of lateral endocardial scar in storm patients (P = 0.05). VA-free survival (36% vs. 47%, P = 0.004) and survival free of death/transplant, however, were worse in NICM storm than nonstorm patients (72% vs. 88%, P = 0.001). NICM storm patients had worse VA-free survival than ICM storm patients. Conclusion: There are differences in clinical factors and scar patterns in patients undergoing VT ablation who present with VT storm versus thosewith a nonstorm presentation. Clinical outcomes areworse in NICM storm patients.
- Subjects
AUSTRALIA; CORONARY heart disease treatment; EVALUATION of medical care; CATHETER ablation; CONFIDENCE intervals; IMPLANTABLE cardioverter-defibrillators; RESEARCH methodology; MULTIVARIATE analysis; MYOCARDIAL depressants; RESEARCH funding; STATISTICAL sampling; STATISTICS; SURVIVAL; TIME; RETROSPECTIVE studies; VENTRICULAR tachycardia; DESCRIPTIVE statistics; ODDS ratio; VENTRICULAR ejection fraction; DISEASE complications; THERAPEUTICS
- Publication
Journal of Cardiovascular Electrophysiology, 2017, Vol 28, Issue 1, p56
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.13117