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. 2011 Jan;52(1):26-32.
doi: 10.3349/ymj.2011.52.1.26.

Electrical storms in patients with an implantable cardioverter defibrillator

Pil Sang Song  1 , June Soo Kim, Dae-Hee Shin, Jung Wae Park, Ki In Bae, Chang Hee Lee, Dong Chae Jung, Dong Ryeol Ryu, Young Keun On
Affiliations

Electrical storms in patients with an implantable cardioverter defibrillator

Pil Sang Song et al. Yonsei Med J. 2011 Jan.

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 ± 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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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Presumed etiologic factors of electrical storm. Cause assignment was made by the physician at the time the electrical storm occurred. CHF, congestive heart failure.
See this image and copyright information in PMC

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