Abstract 12976: Malignant Type of Electrical Storm in Patients With an Implantable Cardiac Shock Device: Results From the Nippon Storm Study
Introduction: Electrical storm (ES) referred to as multiple device therapies is an important clinical problem in patients (pts) with an implantable cardiac shock device (ICSD), such as implantable cardioverter-defibrillator or cardiac resynchronization therapy device with defibrillator. Detailed clinical aspects of ES, however, remain unclear in the Asian large population.
Methods: We analyzed the data of the Nippon Storm Study which was a prospective observational study and consisted of 1570 pts enrolled from 48 Japanese ICSD centers designed to clarify the clinical aspects of ES. The study population included 493 (31%) pts with ischemic heart disease (IHD) and 357 (23%) pts with dilated cardiomyopathy (DCM). They had a mean LVEF of 43±19 %.
Results: ES occurred in 96 (6.4%) pts during a median follow-up of 28 (23-33) months. Compared to pts without ES, pts with ES showed a significantly lower left ventricular ejection fraction (43% vs 38 %, respectively, p=0.005). No significant difference regarding ES incidence was observed between pts with IHD and pts with DCM (log-rank p=0.77). A sub-analysis of the ES characteristics revealed that the mortality in patients with shock therapy during the first ES episode and those with the incidence of multiple episodes of ES during the follow-up was significantly higher than those without (12/18 vs 30/78; p=0.03, 12/18 vs 26/78, p<0.01, respectively, Table).
Conclusions: Shock therapy during the first ES episode and multiple episodes of ES were related to significantly higher mortality in pts with ICSD. There can be a malignant entity of ES.
- Ventricular tachycardia
- Ventricular fibrillation
- Implantable cardiovertor defibrillator
Author Disclosures: T. Noda: Honoraria; Significant; Medtronic Japan. T. Kurita: Honoraria; Significant; St J Med. Japan, Boston Scientific Japan, Bitronik Japan, Medtronic Japan. T. Nitta: None. H. Frushima: None. N. Matsumoto: None. T. Toyoshima: None. A. Shimizu: None. H. Mitamura: None. T. Ohe: None. Y. Aizawa: None.
- © 2015 by American Heart Association, Inc.