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

Electrical storm (ES) is a life-threatening condition that may lead to recurrent arrhythmias, need for ventricular mechanical support, and death. The study aimed to assess the burden of arrhythmia recurrence and in-hospital outcomes of patients admitted for ES in a large urban hospital. We performed a retrospective analysis of patients admitted with ventricular arrhythmias from January 2018 to June 2021 and identified 61 patients with ES, defined as 3 or more episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) within 24 hours. We reviewed the in-hospital outcomes and compared outcomes between patients who had no recurrence of VT/VF after the first 24 hours (34 [56%]), those with recurrence of 1 or 2 episodes of VT/VF within a 24-hour period (15 [24%]), and patients with 3 or more recurrent VT/VF events consistent with recurrent ES after the first 24 hours (12 [20%]). Patients with recurrent ES had significantly higher in-hospital mortality as compared with those with recurrent VT/VF not meeting criteria for ES or no recurrences of VT/VF (3 [25%] vs 0 [0%] vs 0 [0%]; p = 0.002). Moreover, patients with recurrent ES also had higher rates of the combined end points of ventricular mechanical support and death (7 [58%] vs 1 [6%] vs 1 [3%], p < 0.001), invasive mechanical ventilation and death (10 [83%] vs 2 [13%] vs 2 [6%], p < 0.001), catheter ablation or death (12 [100%] vs 7 [47%] vs 12 [35%], p < 0.001) and heart transplantation and death (3 [25%] vs 2 [13%] vs 0 [0%], p = 0.018). In conclusion, patients admitted with ES have a high risk of in-hospital recurrence, associated with extremely poor outcomes. (C) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study investigated the burden of arrhythmia recurrence and in-hospital outcomes among patients admitted for Electrical Storm (ES). The study found that patients with recurrent ES had significantly higher in-hospital mortality rates and higher rates of ventricular mechanical support, invasive mechanical ventilation, catheter ablation, and heart transplantation compared to those with recurrent ventricular tachycardia (VT)/ventricular fibrillation (VF) not meeting criteria for ES or no recurrences of VT/VF.