© 2000 by European Society of Cardiology
Is electrical storm in ICD patients the sign of a dying heart?
Outcome of patients with clusters of ventricular tachyarrhythmias
Division of Cardiology, St Michael's Hospital Toronto and The Department of Medicine, University of Toronto Toronto, Canada
BACKGROUND: Electrical storm in patients with implanted cardioverter defibrillators (ICDs) is purported to carry an ominous prognosis.
METHODS AND RESULTS: We retrospectively compared 40 patients with electrical storm (defined as three or more episodes of ventricular arrhythmia requiring ICD therapy in a 24 h period) with those only having isolated appropriate ICD therapy (n=57) and with patients having no or only inappropriate ICD therapy (n=125). All patients received ICDs for documented sustained VT or VF. There was no significant difference in age, sex, ejection fraction, total follow-up time, or underlying heart disease between any of the three groups. Patients who had electrical storm received their first appropriate ICD therapy 275±369 days post-implant (35% had storm as their first event) with storm occurring an average of 599±710 days post-implant. Patients had 1·5±1·0 storms in total (median=1), with 55±91 episodes per storm. There were no significant differences in actuarial survival at 5-year follow-up between the three groups. Eighty percent of storm patients were alive 5 years post-implant.
CONCLUSION: Storm is a common occurrence in ICD patients, can occur at any time during the follow-up period, and does not independently confer increased mortality.
Key Words: Implantable cardioverter defibrillators, survival, antiarrhythmia agents, electrical storm
Correspondence: Paul Dorian, St Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8.
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