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Clinical features of electrical storm of ventricular tachycardia of patients with implantable cardioverter defibrillator

CAO Dong-lai1,2, LI Chang1, WANG Yi-Long1, SU Kan1, GU Gang1   

  1. 1.Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Training Base for Cardiac Arrhythmia Intervention, Ministry of Health, Shanghai 200025; 2.Changshu Hospital Affiliated to Soochow University, Changshu 215500
  • Online:2016-02-28 Published:2016-03-29

Abstract:

Objective To analyze the clinical features and treatment of electrical storm (ES) of ventricular tachycardia after operation for patients with implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator (ICD/CRT-D). Methods Eighty-nine patients with ICD/CRT-D were followed up regularly to collect relevant data and analyze the onset characteristics of electrical storm of ventricular tachycardia, related risk factors, and corresponding treatment outcomes. Results Nineteen patients (21.3%) experienced at least one episode of ES during the follow up. Among them, 11 patients experienced two or more episodes of ES. 14 patients (73.7%) experienced the first episode of ES within one year after ICD operation. Monomorphic ventricular tachycardia (VT)(68.4%) was the main arrhythmic type of ES and no obvious causes were identified for the onset of ES of most patients (68.4%). The multivariate logistic regression analysis showed that as the secondary prevention of sudden cardiac death, ICD was an independent risk factor of the onset of ES (P=0.014 2). The onset times of ES of patients with coronary atherosclerotic cardiopathy and dilated cardiomyopathy implanted with CRT-D was less than those of patients implanted with ICD (P=0.033). The mortality rate of ES group was not significantly higher. Conclusion ES is common for patients with ICD. The incidence of ES of patients with ICD for secondary prevention of sudden cardiac death is significantly higher than that of patients for primary prevention. The onset of ES of patients with coronary atherosclerotic cardiopathy and dilated cardiomyopathy who have implanted the CRT-D is less common.

Key words: implantable cardioverter defibrillator, electrical storm, ventricular tachycardia