Objectives: The study sought to assess retrospectively the prognostic impact of left ventricular ejection fraction (LVEF) in patients with electrical storm (ES).
Background: Data regarding the prognostic impact of impaired LVEF in ES patients is rare.
Methods: Consecutive patients presenting with ES from 2002 to 2016 were included retrospectively. Patients with LVEF ≤ 35% were compared to patients with LVEF > 35%. The primary prognostic endpoint was long-term all-cause mortality, and secondary endpoints were rates of in-hospital mortality, rehospitalization, major adverse cardiac events (MACE), and ES recurrences (ES-R) at long-term follow-up.
Results: A total of 80 patients with ES were included at 2.5 years of follow-up. 69% of patients suffered from LVEF ≤ 35%. ES patients with LVEF ≤ 35% were associated with higher rates of the primary endpoint of all-cause mortality (53% versus 8%, log-rank p = 0.0001; HR 8.524; 95% CI 2.030-35.793, p = 0.003), as well as the secondary endpoints of MACE (53% versus 20%; log rank p = 0.011; HR 3.213, 95% CI 1.241-8.316, p = 0.016) and ES-R (35% versus 8%; log rank p = 0.019; HR 4.821, 95% CI 1.122-20.706, p = 0.034). Furthermore, ES patients with LVEF ≤ 35% showed higher rates of rehospitalization due to acute heart failure (24% versus 8%, statistical trend p = 0.096). Notably, ES patients with LVEF > 35% were associated with increased rates of rehospitalization due to ventricular tachycardia (36% versus 18%, statistical trend p = 0.083).
Conclusions: ES patients with LVEF ≤ 35% were associated with increased rates of all-cause mortality, MACE, ES-R and heart failure-related rehospitalization at long-term follow-up. This study evaluated retrospectively the prognostic impact of LVEF in patients with ES. LVEF ≤ 35% was associated with increased long-term all-cause mortality (53% versus 8%; HR 8.524; 95% CI 2.030-35.793, p = 0.003), MACE (53% versus 20%; HR 3.213, 95% CI 1.241-8.316, p = 0.016), and ES recurrences (35% versus 8%; HR 4.821, 95% CI 1.122-20.706, p = 0.034), while trends were observed for higher rates of heart-failure related rehospitalization (24% versus 8%, p = 0.096) and MACE (49% versus 28%; p = 0.081).
Keywords: Acute heart failure; Electrical storm; Heart failure; Hospitalization; Left ventricular ejection fraction; MACE; Mortality; Sudden cardiac death.
Prognostic Impact of Recurrences in Patients With Electrical StormJ Müller et al. Scand Cardiovasc J 53 (2), 71-76. PMID 30958708.At long-term follow-up of 2.5 years, ES-R was associated with numerically higher rates of long-term all-cause mortality and significantly higher rates of rehospitalizatio …
Prognostic Impact of Atrial Fibrillation in Electrical StormJ Müller et al. Cardiology 144 (1-2), 9-17. PMID 31527375.In ES patients, presence of AF was univariably associated with increased rates of all-cause mortality at 2.5 years. Furthermore, AF was multivariably associated with over …
Electrical Storm Is Associated With Impaired Prognosis Compared to Ventricular TachyarrhythmiasM Behnes et al. Int J Cardiol 292, 119-125. PMID 31076250.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 v …
Effectiveness and Tolerability of Administration of Granulocyte Colony-Stimulating Factor on Left Ventricular Function in Patients With Myocardial Infarction: A Meta-Analysis of Randomized Controlled TrialsS Kang et al. Clin Ther 29 (11), 2406-18. PMID 18158081. - ReviewBased on the studies included in this meta-analysis, G-CSF treatment improved the LVEF in AMI (but not OMI) at 3 to 12 months follow-up. Treatment with G-CSF was generall …
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