Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Heart Rhythm Année : 2019

Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study

1 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
2 UR - Université de Rennes
3 LTSI - Laboratoire Traitement du Signal et de l'Image
4 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
7 UB - Université de Bordeaux
8 UNISTRA - Université de Strasbourg
9 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
10 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Service de chirurgie thoracique et cardio-vasculaire
13 CHU Nantes - Centre Hospitalier Universitaire de Nantes
14 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
15 Hôpital Michallon
16 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
17 TIMONE - Hôpital de la Timone [CHU - APHM]
18 Hôpital Louis Pradel [CHU - HCL]
19 CHU Rouen
20 Service de Cardiologie [CHU Rouen]
21 CHU Caen
22 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
23 Hôpital Henri Mondor
24 Service de cardiologie
25 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
26 CHU Clermont-Ferrand
27 HEGP - Hôpital Européen Georges Pompidou [APHP]
28 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
29 Service de Cardiologie [CHRU Nancy]
30 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
Daniel Grinberg
  • Fonction : Auteur
  • PersonId : 915405
P.Y. Litzler
  • Fonction : Auteur
Gerard Babatasi
  • Fonction : Auteur
Annette Belin
  • Fonction : Auteur
Nicolas Lellouche
  • Fonction : Auteur
  • PersonId : 764872
  • IdRef : 075154625
Nicolas d'Ostrevy
  • Fonction : Auteur
  • PersonId : 1345629
  • IdHAL : ndostrevy

Résumé

Background - Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes. Objective - We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients. Methods - Patients analyzed were those included in the multicenter ASSIST-ICD observational study. ES was consensually defined as occurrence of ≥3 separate episodes of sustained VAs within a 24-hour interval. Results - Of 652 patients with an LVAD, 61 (9%) presented ES during a median follow-up period of 9.1 (interquartile range [IQR] 2.5-22.1) months. The first ES occurred after 17 (IQR 4.0-56.2) days post LVAD implantation, most of them during the first month after the device implantation (63%). The incidence then tended to decrease during the initial years of follow-up and increased again after the third year post LVAD implantation. History of VAs before LVAD implantation and heart failure duration > 84 months were independent predictors of ES. The occurrence of ES was associated with an increased early mortality since 20 patients (33%) died within the first 2 weeks of ES. Twenty-two patients (36.1%) presented at least 1 recurrence of ES, occurring 43.0 (IQR 8.0-69.0) days after the initial ES. Patients experiencing ES had a significantly lower 1-year survival rate than did those free from ES (log-rank, P = .039). Conclusion - There is a significant incidence of ES in patients with an LVAD. The short-term mortality after ES is high, and one-third of patients will die within 15 days. Whether radiofrequency ablation of arrhythmias improves outcomes would require further studies.
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Dates et versions

hal-02169759 , version 1 (12-06-2020)

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R.P. Martins, Christophe Leclercq, Hamed Bourenane, Vincent Auffret, S. Boulé, et al.. Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study. Heart Rhythm, 2019, 16 (10), pp.1506-1512. ⟨10.1016/j.hrthm.2019.06.021⟩. ⟨hal-02169759⟩
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