Is electrical storm in ICD patients the sign of a dying heart? Outcome of patients with clusters of ventricular tachyarrhythmias

Europace. 2000 Jul;2(3):263-9. doi: 10.1053/eupc.2000.0104.

Abstract

Background: Electrical storm in patients with implanted cardioverter defibrillators (ICDs) is purported to carry an ominous prognosis.

Methods and results: We retrospectively compared 40 patients with electrical storm (defined as three or more episodes of ventricular arrhythmia requiring ICD therapy in a 24 h period) with those only having isolated appropriate ICD therapy (n=57) and with patients having no or only inappropriate ICD therapy (n=125). All patients received ICDs for documented sustained VT or VF. There was no significant difference in age, sex, ejection fraction, total follow-up time, or underlying heart disease between any of the three groups. Patients who had electrical storm received their first appropriate ICD therapy 275 +/- 369 days post-implant (35% had storm as their first event) with storm occurring an average of 599 +/- 710 days post-implant. Patients had 1.5 +/- 1.0 storms in total (median= 1), with 55 +/- 91 episodes per storm. There were no significant differences in actuarial survival at 5-year follow-up between the three groups. Eighty percent of storm patients were alive 5 years post-implant.

Conclusion: Storm is a common occurrence in ICD patients, can occur at any time during the follow-up period, and does not independently confer increased mortality.

Publication types

  • Comparative Study

MeSH terms

  • Defibrillators, Implantable*
  • Female
  • Heart Transplantation
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tachycardia, Ventricular / mortality
  • Tachycardia, Ventricular / physiopathology*
  • Tachycardia, Ventricular / surgery
  • Ventricular Fibrillation / mortality
  • Ventricular Fibrillation / physiopathology*
  • Ventricular Fibrillation / surgery