Predicting Survival in Ventricular Tachycardia Storm: The CHAMPS Risk Score and Implications for Ablation Timing

Area of Science:

• Cardiology
• Electrophysiology
• Critical Care Medicine

Background:

• Ventricular tachycardia (VT) storm is a critical condition with a significant risk of in-hospital mortality.
• Limited data exists on identifying high-risk patients and optimal timing for catheter ablation in VT storm.
• This study addresses these gaps by analyzing predictors and ablation timing in VT storm patients.

Purpose of the Study:

• To identify predictors of in-hospital mortality in patients experiencing VT storm.
• To develop a clinical risk score (CHAMPS) for stratifying mortality risk.
• To evaluate the impact of catheter ablation timing on survival across different risk strata.

Main Methods:

• Retrospective analysis of 1,675 patients with VT storm from six tertiary care centers (2015-2024).
• Multivariable logistic regression identified mortality predictors, forming the basis for the CHAMPS score.
• Comparison of mortality rates across risk strata and by ablation timing.

Main Results:

• In-hospital mortality was 22% (363/1,675 patients).
• Key mortality predictors included cerebrovascular accident, hypoxia, non-VT admission diagnosis, malnutrition, vasopressor use, and sepsis.
• The CHAMPS score stratified patients into low (6.6%), moderate (26.7%), and high (60.7%) mortality risk groups.
• Early VT ablation (within 7 days) was protective against in-hospital mortality (OR: 0.01), independent of the CHAMPS score.

Conclusions:

• The CHAMPS score effectively identifies patients at high risk of mortality during VT storm.
• Early catheter ablation demonstrates a significant survival benefit for VT storm patients, irrespective of their risk score.
• These findings support risk stratification and timely intervention for improved outcomes in VT storm.