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

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Title: Electrical storm reveals worse prognosis compared to myocardial infarction complicated by ventricular tachyarrhythmias in ICD recipients
Authors: Julian Müller, Michael Behnes, Tobias Schupp, Dominik Ellguth, Gabriel Taton, Linda Reiser, Niko Engelke, Martin Borggrefe, Thomas Reichelt, Armin Bollow, Ibrahim El-Battrawy, Kathrin Weidner, Seung-Hyun Kim, Christian Barth, Uzair Ansari, Dirk Große Meininghaus, Muharrem Akin, Kambis Mashayekhi, Ibrahim Akin
Source: Heart Vessels
Publisher Information: Springer Science and Business Media LLC, 2021.
Publication Year: 2021
Subject Terms: 2. Zero hunger, Myocardial Infarction, Stroke Volume, Myocardial Infarction/therapy [MeSH], Defibrillators, Implantable [MeSH], Electrical storm, Heart failure, Humans [MeSH], Tachycardia, Ventricular/etiology [MeSH], Acute heart failure, Retrospective Studies [MeSH], Risk Factors [MeSH], Tachycardia, Ventricular/diagnosis [MeSH], Acute myocardial infarction, Hospitalization, Sudden cardiac death, Original Article, Ventricular Function, Left/physiology [MeSH], Tachycardia, Ventricular/therapy [MeSH], Mortality, Myocardial Infarction/complications [MeSH], MACE, Prognosis [MeSH], Stroke Volume [MeSH], Ventricular fibrillation, Ventricular tachycardia, Prognosis, Ventricular Function, Left, Defibrillators, Implantable, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Tachycardia, Ventricular, Humans, 10. No inequality, Retrospective Studies
Description: Both 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 2002 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) 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 rehospitalization: HR = 2.887; 95% CI 1.240–6.720; p = 0.014). In contrast, the rates of MACE (40% vs. 32%; p = 0.326) were comparable in both groups. At long-term follow-up of 3 years, ES was associated with higher rates of all-cause mortality and rehospitalization compared to patients with AMI–VTA.
Document Type: Article
Other literature type
File Description: pdf
Language: English
ISSN: 1615-2573
0910-8327
DOI: 10.1007/s00380-021-01844-9
Access URL: https://link.springer.com/content/pdf/10.1007/s00380-021-01844-9.pdf
https://pubmed.ncbi.nlm.nih.gov/33900449
https://link.springer.com/article/10.1007/s00380-021-01844-9
https://link.springer.com/content/pdf/10.1007/s00380-021-01844-9.pdf
https://pubmed.ncbi.nlm.nih.gov/33900449/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481166
https://europepmc.org/article/MED/33900449
https://repository.publisso.de/resource/frl:6451089
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Accession Number: edsair.doi.dedup.....cea9d0d3081bafbba1e57815d9427267
Database: OpenAIRE
Description
Abstract:Both 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 2002 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) 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 rehospitalization: HR = 2.887; 95% CI 1.240–6.720; p = 0.014). In contrast, the rates of MACE (40% vs. 32%; p = 0.326) were comparable in both groups. At long-term follow-up of 3 years, ES was associated with higher rates of all-cause mortality and rehospitalization compared to patients with AMI–VTA.
ISSN:16152573
09108327
DOI:10.1007/s00380-021-01844-9