Long-Term Outcomes of Catheter Ablation in Ventricular Tachycardia Electrical Storm: A Retrospective Cohort Study
Cem Çöteli1, Samuray Zekeriyayev1, Can Sezer1
1Department of Cardiology, Hacettepe University Adult Hospital, Altındağ, Ankara, Türkiye.
Insights
Catheter ablation for electrical storm is safe, but long-term risks of mortality and ventricular tachycardia (VT) recurrence remain high in patients with structural heart disease.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Electrical storm is a life-threatening condition in patients with structural heart disease.
- Catheter ablation is an emerging treatment, but long-term outcomes require evaluation.
Purpose of the Study:
- To assess long-term outcomes of catheter ablation for electrical storm.
- Focus on mortality, ventricular tachycardia (VT) recurrence, and hospitalization rates.
Main Methods:
- Retrospective cohort study of 65 patients with electrical storm undergoing catheter ablation.
- Primary outcome: VT-related ICD therapies. Secondary outcomes: mortality, VT recurrence, hospitalization, stroke.
Main Results:
- Procedures were safe with high acute success (93.85%).
- 33.85% received VT-related ICD therapies; 40% died during follow-up.
- Reduced LVEF was a predictor of mortality; 72% experienced composite endpoint.
Conclusions:
- VT ablation is safe and effective for acute management of electrical storm.
- Patients remain at high risk for long-term morbidity and mortality.
- Reduced LVEF is a significant predictor of poor long-term outcomes.
Background And Objective:
Electrical storm is a life-threatening condition commonly observed in patients with structural heart disease. While catheter ablation has emerged as an effective treatment for electrical storm, the long-term outcomes are still unknown. This study aims to evaluate the long-term outcomes of catheter ablation in patients with electrical storm, focusing on mortality, ventricular tachycardia (VT) recurrence, and hospitalization rates.
Methods:
We conducted a retrospective cohort study at a single center, enrolling 65 patients admitted with electrical storm. All patients underwent catheter ablation The primary outcome was VT-related ICD therapies, while the secondary outcomes included all caused mortality, VT-related ICD therapies, repeat ablation, hospitalization, and stroke.
Results:
The cohort was predominantly male (86.15%) with ischemic cardiomyopathy (56.92%) and a mean left ventricular ejection fraction (LVEF) of 35.3% ± 13%. All procedures were completed without any fatalities and without significant complications in 93.85% of cases. During follow-up, 22 patients (33.85%) received ICD therapies for VT. The median estimated survival time for the VT-free survival was 43 months. The 12-month mortality rate was 26.15%. Over the median follow-up of 23 months, 40% of patients died, and 72% experienced a composite endpoint of death, VT recurrence, or hospitalization. Multivariate analysis identified reduced LVEF as the strongest predictor of mortality during follow-up.
Conclusion:
VT ablation is a safe and effective therapeutic option for managing electrical storm, providing high acute procedural success and allowing most patients to be discharged. However, this high-risk population remains at significant risk for long-term morbidity and mortality.
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