1
|
Faga V, Anguera I, Oloriz T, Nombela-Franco L, Teruel L, Dallaglio PD, Perez Guerrero A, Gomez Hospital JA, Rodriguez Garcia J, Rodriguez Garcia MA, Adelino Recasens R, Merce J, Viedma J, Comin Colet J, Di Marco A. Improved prediction of electrical storm in patients with prior myocardial infarction and implantaImproved prediction of electrical storm in patients with prior myocardiable cardioverter defibrillator. Europace 2022. [DOI: 10.1093/europace/euac053.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aims
To evaluate predictors of electrical storm (ES), including chronic total occlusion in an infarct-related coronary artery (infarct-related artery CTO, IRACTO), in a cohort of patients with prior myocardial infarction (MI) and implantable cardioverter-defibrillators (ICD).
Methods
Multicenter observational cohort study including 643 consecutive patients with prior MI and a first ICD implanted between 2005 and 2018 at three tertiary hospitals. All the patients included in the study had undergone a diagnostic coronary angiography before ICD implantation. The variable prior ventricular arrhythmias (VA+) was positive in patients with secondary prevention ICDs and in those with at least one appropriate ICD therapy after primary prevention implantation.
Results
During a median follow-up of 42 months 59 patients (9%) suffered ES. The presence of at least one IRACTO not revascularized (IRACTO-NR) was associated with a significantly higher cumulative incidence of ES (14.5% vs 4.8%, p<0.001). IRACTO-NR maintained a significant association with ES after adjustment for potential confounders (HR 2.3, p=0.005) and was an independent predictor of ES together with VA+ and LVEF. The best cut-off of LVEF to predict ES was ≤38%. A risk-prediction model based on IRACTO-NR, VA+ and LVEF≤38% identified three categories of ES risk (low, intermediate and high), with progressively increasing cumulative incidence of ES (2.2%, 9% and 20%).
Conclusion
In a cohort of patients with prior MI and ICD, IRACTO-NR is an independent predictor of ES. A new risk-prediction model allowed the identification of three categories of risk, with potentially important clinical implications.
Collapse
Affiliation(s)
- V Faga
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - I Anguera
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - T Oloriz
- University Hospital Miguel Servet, Cardiology department, Zaragoza, Spain
| | - L Nombela-Franco
- Hospital Clinico San Carlos, Cardiology department, Madrid, Spain
| | - L Teruel
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - PD Dallaglio
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - A Perez Guerrero
- University Hospital Miguel Servet, Cardiology department, Zaragoza, Spain
| | - JA Gomez Hospital
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - J Rodriguez Garcia
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - MA Rodriguez Garcia
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - R Adelino Recasens
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - J Merce
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - J Viedma
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - J Comin Colet
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| | - A Di Marco
- University Hospital of Bellvitge, Cardiology department, Hospitalet De Llobregat, Spain
| |
Collapse
|
2
|
Calvo N, Juez A, Oloriz T, Asso A, Calvo I. P1474Long-term effectiveness and complications of ICDs in patients with hypertrophic cardiomyopathy. Europace 2017. [DOI: 10.1093/ehjci/eux158.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|