Outcome of rescue ablation in patients with refractory ventricular electrical storm requiring mechanical circulation support
Fa-Po Chung MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorYing-Chieh Liao MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Department of medicine, Division of cardiology, Changhua Christian Hospital, Changhua, Taiwan
Search for more papers by this authorYenn-Jiang Lin MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorShih-Lin Chang MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorLi-Wei Lo MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorYu-Feng Hu MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTa-Chuan Tuan MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTze-Fan Chao MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorJo-Nan Liao MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorChin-Yu Lin MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTing-Yung Chang MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorJennifer Jeanne B. Vicera MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
University of Santo Tomas Hospital, Manila, Philippines
Search for more papers by this authorChye-Gen Chin MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Search for more papers by this authorCheng-I Wu MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorChih-Min Liu MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorPo-Tseng Lee MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
National Cheng-Kung University Hospital, Tainan, Taiwan
Search for more papers by this authorTing-Chun Huang MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
National Cheng-Kung University Hospital, Tainan, Taiwan
Search for more papers by this authorIsaiah C. Lugtu BS, MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Shih-Ann Chen MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Correspondence Shih-Ann Chen, MD, Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
Email: [email protected]
Search for more papers by this authorFa-Po Chung MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorYing-Chieh Liao MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Department of medicine, Division of cardiology, Changhua Christian Hospital, Changhua, Taiwan
Search for more papers by this authorYenn-Jiang Lin MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorShih-Lin Chang MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorLi-Wei Lo MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorYu-Feng Hu MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTa-Chuan Tuan MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTze-Fan Chao MD, PhD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorJo-Nan Liao MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorChin-Yu Lin MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTing-Yung Chang MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorJennifer Jeanne B. Vicera MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
University of Santo Tomas Hospital, Manila, Philippines
Search for more papers by this authorChye-Gen Chin MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Search for more papers by this authorCheng-I Wu MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorChih-Min Liu MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorPo-Tseng Lee MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
National Cheng-Kung University Hospital, Tainan, Taiwan
Search for more papers by this authorTing-Chun Huang MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
National Cheng-Kung University Hospital, Tainan, Taiwan
Search for more papers by this authorIsaiah C. Lugtu BS, MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Shih-Ann Chen MD
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Cardiovascular Research Center, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Correspondence Shih-Ann Chen, MD, Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan.
Email: [email protected]
Search for more papers by this authorAbstract
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.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
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