Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support

Fa Po Chung, Ying Chieh Liao, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Chin Yu Lin, Ting Yung Chang, Jennifer Jeanne B. Vicera, Chye Gen Chin, Cheng I. Wu, Chih Min Liu, Po Tseng Lee, Ting Chun Huang, Isaiah C. Lugtu, Shih Ann Chen

Research output: Contribution to journalArticle

Abstract

Background: The management of refractory electrical storm (ES) requiring mechanical circulation support (MCS) remains a clinical challenge in structural heart disease (SHD). Objective: The study sought to explore the 30-day and 1-year outcome of rescue ablation for refractory ES requiring MCS in SHD. Methods: A total of 81 patients (mean age: 55.3 ± 18.9, 73 men [90.1%]) undergoing ablation were investigated, including 26 patients with ES requiring MCS (group 1) and 55 patients without (group 2). The 30-day and 1-year outcome, including mortality and recurrent ventricular tachyarrhythmias (VAs) receiving appropriate implantable cardioverter defibrillators therapies, were assessed. Results: The patients in group 1 were characterized by older age, more ischemic cardiomyopathies, worse left ventricular ejection fraction, and more comorbidities. Thirty days after ablation, overall events were seen in 15 patients (mortality in 10 and recurrent VA in 7), including pumping failure-related mortality in 6 (60%). During a 30-day follow-up, higher mortality was noted in group 1. After a 1-year follow-up, in spite of the higher mortality in group 1 (P <.001), the overall events and VA recurrences were similar between these two groups (P =.154 and P =.466, respectively). There was a significant reduction of VA burden in both groups and two patients had recurrent ES. Conclusion: Higher 30-day mortality was observed in patients undergoing rescue ablation for refractory ES requiring MCS, and pumping failure was the major cause of periprocedural death. Rescue ablation successfully prevented VA recurrences and resulted in a comparable 1-year prognosis between ES with and without MCS.

Original languageEnglish
Pages (from-to)9-17
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume31
Issue number1
DOIs
Publication statusPublished - 2020 Jan 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Chung, F. P., Liao, Y. C., Lin, Y. J., Chang, S. L., Lo, L. W., Hu, Y. F., Tuan, T. C., Chao, T. F., Liao, J. N., Lin, C. Y., Chang, T. Y., Vicera, J. J. B., Chin, C. G., Wu, C. I., Liu, C. M., Lee, P. T., Huang, T. C., Lugtu, I. C., & Chen, S. A. (2020). Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support. Journal of Cardiovascular Electrophysiology, 31(1), 9-17. https://doi.org/10.1111/jce.14309