Electrical storm in patients with biventricular implantable cardioverter defibrillator: Incidence, predictors, and prognostic implications

Gasparini, Maurizio; Lunati, Maurizio; Landolina, Maurizio; Santini, Claudia; Padeletti, Luigi; Perego, Gianluca; Vincenti, Antonio; Curnis, B. Antonio; Carboni, Angelo; Denaro, Alessandra; Spotti, A.; Grammatico, Andrea; Regoli, François; Boriani, Giuseppe

doi:10.1016/j.ahj.2008.06.035

Cited by 30 publications

(29 citation statements)

References 30 publications

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“…Several studies have suggested that CRT (epicardial LV pacing) may promote VA, possibly due to reversal of the normal sequence of activation induced by LV epicardial pacing that may lead to prolongation of the QT interval and an increase in the transmural dispersion of repolarization . Gasparini et al reported that electrical storm occurred in 45 (7%) of 631 CRT‐D patients . Our study was similar to indicate that upgrade CRT‐D significantly decreased VA episodes, while 14 patients increased VA episodes after upgrade CRT‐D.…”

Section: Discussionmentioning

confidence: 95%

Association left ventricular lead and ventricular arrhythmias after upgrade to cardiac resynchronization therapy in patients with implantable cardioverter defibrillators

Kawamura

Arai

Yoshikawa

et al. 2019

Clinical Cardiology

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Background There are some controversial reports related to the pro‐arrhythmic or anti‐arrhythmic potential of cardiac resynchronization therapy (CRT) and little is known about the relationship between ventricular arrhythmia (VA) and left ventricular (LV)‐lead threshold. Hypothesis Upgrade CRT is anti‐arrhythmic effect of VA with implantable cardioverter‐defibrillator (ICD) patients and has a relationship with the incident of VA and LV‐lead threshold. Methods Among 384 patients with the implantation of CRT‐defibrillator (CRT‐D), 102 patients underwent an upgrade from ICD to CRT‐D. We divided patients into three groups; anti‐arrhythmic effect after upgrade (n = 22), pro‐arrhythmic effect (n = 14), and unchanging‐VA events (n = 66). The VA event was determined by device reports. We described the electrocardiography parameters, LV‐lead characteristics, and clinical outcomes. Results Before upgrade, the numbers of VA were 305 episodes and the numbers of ICD therapy were 157 episodes. While after upgrade, the numbers of VA were 193 episodes and the number of ICD therapy were 74 episodes. Ventricular tachycardia cycle length (VT‐CL) after upgrade was significantly slower as compared to those with before upgrade. Pro‐arrhythmic group was significantly higher with delta LV‐lead threshold (after 1 month—baseline) as compared to those with anti‐arrhythmic group (0.74 vs −0.21 V). Furthermore, pro‐arrhythmic group was significantly bigger with delta VT‐CL (after 3 months—before 3 months) as compared to those with anti‐arrhythmic group ( P = .03). Conclusions We described upgrade‐CRT was associated with reduction of VA, ICD therapies and VT‐CL. While 14 patients had a pro‐arrhythmic effect and LV lead threshold might be associated with VA‐incidents.

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Section: Discussionmentioning

confidence: 95%

Association left ventricular lead and ventricular arrhythmias after upgrade to cardiac resynchronization therapy in patients with implantable cardioverter defibrillators

Kawamura

Arai

Yoshikawa

et al. 2019

Clinical Cardiology

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“…Among patients with ICD implantation for ischemic and non-ischemic cardiomyopathy in the setting of primary SCD prevention, 10–30% will have ES over 2 to 3 years of follow-up1,17,49,[50]. Implantation of cardiac resynchronization therapy (CRT) has also temporally been related to ES51,[52], but occurring at a lower rate of approximately 1–4% of patients[53]. In primary prevention patients from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II), the hazard ratio of death was almost 18-fold higher in the 3 months after ES, compared to patients without any documented ventricular tachyarrhythmias[54].…”

Section: Substrates and Mechanisms For Ventricular Tachyarrhythmiasmentioning

confidence: 99%

Optimal antiarrhythmic drug therapy for electrical storm

2015

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Electrical storm, defined as 3 or more separate episodes of ventricular tachycardia or ventricular fibrillation within 24 hours, carries significant morbidity and mortality. These unstable ventricular arrhythmias have been described with a variety of conditions including ischemic heart disease, structural heart disease, and genetic conditions. While implantable cardioverter defibrillator implantation and ablation may be indicated and required, antiarrhythmic medication remains an important adjunctive therapy for these persons.

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“…The findings vary from 4% to 28% in the first three years [9], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40]. The reasons for the differences in prevalence result from different screening instruments.…”

Section: Current Researchmentioning

confidence: 99%

Manual for the psychotherapeutic treatment of acute and post-traumatic stress disorders following multiple shocks from implantable cardioverter defibrillator (ICD)

Jordan

Titscher

Peregrinova

et al. 2013

GMS Psycho-Social-Medicine; 10:Doc09; ISSN 1860-5214

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Electrical storm in patients with biventricular implantable cardioverter defibrillator: Incidence, predictors, and prognostic implications

Cited by 30 publications

References 30 publications

Association left ventricular lead and ventricular arrhythmias after upgrade to cardiac resynchronization therapy in patients with implantable cardioverter defibrillators

Association left ventricular lead and ventricular arrhythmias after upgrade to cardiac resynchronization therapy in patients with implantable cardioverter defibrillators

Optimal antiarrhythmic drug therapy for electrical storm

Manual for the psychotherapeutic treatment of acute and post-traumatic stress disorders following multiple shocks from implantable cardioverter defibrillator (ICD)

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