Electrical Storms in Patients with an Implantable Cardioverter Defibrillator
Yonsei Medical Journal 2011³â 52±Ç 1È£ p.26 ~ p.32
¼ÛÇÊ»ó(Song Pil-Sang) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
±èÁؼö(Kim June-Soo) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
½Å´ëÈñ(Shin Dae-Hee) - University of Ulsan Gangneung Asan Hospital Division of Cardiology
¹ÚÁ¤¿Ö(Park Jung-Wae) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
(Bae Ki-In) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
ÀÌÀåÈñ(Lee Chang-Hee) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
Á¤µ¿Ã¤(Jung Dong-Chae) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
·ùµ¿·Ä(Ryu Dong-Ryeol) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
¿Â¿µ±Ù(On Young-Keun) - Sungkyunkwan University School of Medicine Samsung Medical Center Division of Cardiology
Abstract
Purpose: In some patients with an implantable cardioverter defibrillator (ICD), multiple episodes of electrical storm (ES) can occur. We assessed the prevalence, features, and predictors of ES in patients with ICD.
Materials and Methods: Eighty-five patients with an ICD were analyzed. ES was defined as the occurrence of two or more ventricular tachyarrhythmias within 24 hours.
Results: Twenty-six patients experienced at least one ES episode, and 16 patients experienced two or more ES episodes. The first ES occurred 209 ¡¾ 277 days after ICD implantation. In most ES cases, the index arrhythmia was ventricular tachycardia (65%). There were no obvious etiologic factors at the onset of most ES episodes (57%). More patients with a structurally normal heart (p = 0.043) or ventricular fibrillation (VF) as the index arrhythmia (p = 0.017) were in the ES-free group. Kaplan-Meier estimates and a log-rank test showed that patients with nonischemic dilated cardiomyopathy (DCMP) (log-rank test, p = 0.016) or with left ventricular ejection fraction < 35% (p = 0.032) were more likely to experience ES, and that patients with VF (p = 0.047) were less affected by ES. Cox proportional hazard regression analysis showed that nonischemic DCMP correlated with a greater probability of ES (hazard ratio, 3.71; 95% confidence interval, 1.16-11.85; p = 0.027).
Conclusion: ES is a common and recurrent event in patients with an ICD. Nonischemic DCMP is an independent predictor of ES. Patients with VF or with a structurally normal heart are less likely to experience ES.
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Implantable cardioverter defibrillators, ventricular tachycardia, ventricular fibrillation
KMID :
0311120110520010026
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À¯È¿¼º°á°ú(Recomendation)
ES is a common and recurrent event in patients with an ICD.