• J. Cardiovasc. Electrophysiol. · Jan 2020

    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, and Shih-Ann Chen.
    • Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
    • J. Cardiovasc. Electrophysiol. 2020 Jan 1; 31 (1): 9-17.

    BackgroundThe management of refractory electrical storm (ES) requiring mechanical circulation support (MCS) remains a clinical challenge in structural heart disease (SHD).ObjectiveThe study sought to explore the 30-day and 1-year outcome of rescue ablation for refractory ES requiring MCS in SHD.MethodsA 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.ResultsThe 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.ConclusionHigher 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.© 2019 Wiley Periodicals, Inc.

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