Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F17%3A00060286" target="_blank" >RIV/00023001:_____/17:00060286 - isvavai.cz</a>

Výsledek na webu

<a href="http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171830&type=printable" target="_blank" >http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171830&type=printable</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1371/journal.pone.0171830" target="_blank" >10.1371/journal.pone.0171830</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm

Popis výsledku v původním jazyce

Aims To investigate predictors of long-term outcomes after catheter ablation (CA) for ventricular tachycardia (VT) and the impact of electrical storm (ES) prior to index ablation procedures. Methods We studied consecutive patients with structural heart disease and VT (n = 328; age: 63 +/- 12 years; 88% males; 72% ischaemic cardiomyopathy; LVEF: 32 +/- 12%) who had undergone CA. According to presenting arrhythmia at baseline, they were divided into ES (n = 93, 28%) and non-ES groups. Clinical predictors of all-cause mortality were investigated and a clinically useful risk score (SCORE) was constructed. Results During a median follow-up of 927 days (IQR: 564-1626), 67% vs. 60% of patients (p = 0.05) experienced VT recurrence in the ES vs. the non-ES group, respectively; and 41% vs. 32% patients died (p = 0.02), respectively. Five factors were independently associated with mortality: age &gt;70 years (hazard ratio (HR): 1.6, 95% confidence interval (CI): 1.1-2.4, p = 0.01), NYHA class &gt;= 3 (HR: 1.9, 95% CI: 1.2-2.9, p = 0.005), a serum creatinine level &gt;1.3 mg/dL (HR: 1.6, 95% CI: 1.1-2.3, p = 0.02), LVEF &lt;= 25% (HR: 2.4, 95% CI: 1.6-3.5, p = 0.00004), and amiodarone therapy (HR: 1.5, 95% CI: 1.0-2.2, p = 0.03). A risk SCORE ranging from 0-4 (1 point for either high-risk age, NYHA, creatinine, or LVEF) correlated with mortality. ES during index ablation independently predicted mortality only in patients with a SCORE &lt;= 1. Conclusions Advanced LV dysfunction, older age, higher NYHA class, renal dysfunction, and amiodarone therapy, but not ES, were predictors of poor outcomes after CA for VT in the total population. However, ES did predict mortality in a low-risk sub-group of patients.

Název v anglickém jazyce

Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm

Popis výsledku anglicky

Aims To investigate predictors of long-term outcomes after catheter ablation (CA) for ventricular tachycardia (VT) and the impact of electrical storm (ES) prior to index ablation procedures. Methods We studied consecutive patients with structural heart disease and VT (n = 328; age: 63 +/- 12 years; 88% males; 72% ischaemic cardiomyopathy; LVEF: 32 +/- 12%) who had undergone CA. According to presenting arrhythmia at baseline, they were divided into ES (n = 93, 28%) and non-ES groups. Clinical predictors of all-cause mortality were investigated and a clinically useful risk score (SCORE) was constructed. Results During a median follow-up of 927 days (IQR: 564-1626), 67% vs. 60% of patients (p = 0.05) experienced VT recurrence in the ES vs. the non-ES group, respectively; and 41% vs. 32% patients died (p = 0.02), respectively. Five factors were independently associated with mortality: age &gt;70 years (hazard ratio (HR): 1.6, 95% confidence interval (CI): 1.1-2.4, p = 0.01), NYHA class &gt;= 3 (HR: 1.9, 95% CI: 1.2-2.9, p = 0.005), a serum creatinine level &gt;1.3 mg/dL (HR: 1.6, 95% CI: 1.1-2.3, p = 0.02), LVEF &lt;= 25% (HR: 2.4, 95% CI: 1.6-3.5, p = 0.00004), and amiodarone therapy (HR: 1.5, 95% CI: 1.0-2.2, p = 0.03). A risk SCORE ranging from 0-4 (1 point for either high-risk age, NYHA, creatinine, or LVEF) correlated with mortality. ES during index ablation independently predicted mortality only in patients with a SCORE &lt;= 1. Conclusions Advanced LV dysfunction, older age, higher NYHA class, renal dysfunction, and amiodarone therapy, but not ES, were predictors of poor outcomes after CA for VT in the total population. However, ES did predict mortality in a low-risk sub-group of patients.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

PLoS ONE [online]

ISSN

1932-6203

e-ISSN

—

Svazek periodika

12

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

13

Strana od-do

"art. no. e0171830"

Kód UT WoS článku

000394244300047

EID výsledku v databázi Scopus

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