Arrhythmic Recurrence and Outcomes in Patients Hospitalized With First Episode of Electrical Storm

Area of Science:

• Cardiology
• Electrophysiology
• Critical Care Medicine

Background:

• Electrical storm (ES) is a critical condition characterized by recurrent ventricular arrhythmias.
• ES can lead to severe consequences including death and the need for advanced interventions.
• Understanding the outcomes of patients admitted for ES is crucial for improving patient management.

Purpose of the Study:

• To evaluate the frequency of arrhythmia recurrence in patients admitted for electrical storm.
• To assess the in-hospital outcomes, including mortality and need for interventions, in patients with ES.
• To compare outcomes based on the severity of arrhythmia recurrence after initial presentation.

Main Methods:

• Retrospective analysis of patients admitted with ventricular arrhythmias between January 2018 and June 2021.
• Identification of 61 patients diagnosed with electrical storm (≥3 VT/VF episodes in 24 hours).
• Comparison of in-hospital outcomes across three groups: no recurrence, recurrence not meeting ES criteria, and recurrent ES.

Main Results:

• Patients with recurrent ES showed significantly higher in-hospital mortality (25%) compared to other groups (0%).
• Recurrent ES was associated with increased rates of ventricular mechanical support (58%), invasive ventilation (83%), catheter ablation (100%), and heart transplantation (25%).
• A significant association was found between recurrent ES and combined endpoints of death, mechanical support, and ventilation.

Conclusions:

• Patients admitted for electrical storm have a substantial risk of in-hospital arrhythmia recurrence.
• Recurrent electrical storm is linked to extremely poor in-hospital outcomes, including high mortality and increased need for interventions.
• The findings underscore the severity of recurrent ES and the need for effective management strategies.