Prognosis at one year after urgent catheter ablation for electrical storm in patients with scar-related left ventricular cardiomyopathy - 09/01/21
Résumé |
Introduction |
Electrical storm (ES) is a severe event in patients with scar-related left ventricular cardiomyopathy. Prognosis factors of ventricular arrhythmias (VA) recurrence and death after catheter ablation (CA) are not clearly identified in this population.
Purpose |
Aims of this study is to identify prognosis factor of VA recurrences and death at 30 days and one year after CA.
Methods |
Patients with scar-related left ventricular cardiomyopathy hospitalised for urgent CA for ES in four tertiary referral university hospitals (AP–HP, Paris) were retrospectively included. Patients’ characteristics, ES management and one-year follow-up were collected.
Results |
In total, 124 patients with scar related left ventricular cardiomyopathy who underwent urgent CA for ES were included. Polymorphic VA (HR=2.15 95% CI [1.16–3.97], P=0.02) was independently associated with VA recurrences at 30 days. Dilated cardiomyopathy (DCM) was associated with VA recurrences (HR=2.25 95% CI [1.31–3.87], P=0.003) whereas beta-blockers at baseline were associated with less VA recurrences (HR=0.46 95% CI [0.26–0.83], P=0.01) at one year. PAINESD Score (HR=1.09 95% CI [1.01–1.19], P=0.04) and need for circulatory support (HR=4.20 95% CI [1.81–9.75], P=0.04) were associated with 30 day-mortality. PAINESD Score (HR=1.10 95% CI [1.03–1.16], P=0.003), DCM (HR=3.52 95% CI [1.75–7.08], P<0.0001) and circulatory support (HR=3.55 95% CI [1.83–6.84], P<0.0001) were associated with one year-mortality. At one year, 22% of patients who underwent cardiac graft and 50% with long-term LVAD died.
Conclusion |
Polymorphic VA is associated with VA recurrence at 30 days. PAINESD score was significantly associated with early and late mortality. Patients with DCM presented a higher risk of VA recurrence and death at one year.
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Vol 13 - N° 1
P. 86 - janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.