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. 2022 Jan;63(1):13-20.
doi: 10.1007/s10840-020-00924-6. Epub 2021 Jan 23.

Chronic kidney disease impairs prognosis in electrical storm

Kathrin Weidner  1 , Michael Behnes  2 , Tobias Schupp  1 , Jorge Hoppner  3 , Uzair Ansari  1 , Julian Mueller  1 , Simon Lindner  1 , Martin Borggrefe  1 , Seung-Hyun Kim  1 , Aydin Huseyinov  1 , Dominik Ellguth  1 , Muharrem Akin  4 , Dirk Große Meininghaus  5 , Thomas Bertsch  6 , Gabriel Taton  1 , Armin Bollow  1 , Thomas Reichelt  1 , Niko Engelke  1 , Linda Reiser  1 , Ibrahim Akin  1
Affiliations

Chronic kidney disease impairs prognosis in electrical storm

Kathrin Weidner et al. J Interv Card Electrophysiol. 2022 Jan.

Abstract

Background: The study sought to assess the prognostic impact of chronic kidney disease (CKD) in patients with electrical storm (ES). ES represents a life-threatening heart rhythm disorder. In particular, CKD patients are at risk of suffering from ES. However, data regarding the prognostic impact of CKD on long-term mortality in ES patients is limited.

Methods: All consecutive ES patients with an implantable cardioverter-defibrillator (ICD) were included retrospectively from 2002 to 2016. Patients with CKD (MDRD-GFR < 60 ml/min/1.73 m2) were compared to patients without CKD. The primary endpoint was all-cause mortality at 3 years. Secondary endpoints were in-hospital mortality, cardiac rehospitalization, recurrences of electrical storm (ES-R), and major adverse cardiac events (MACE) at 3 years.

Results: A total of 70 consecutive ES patients were included. CKD was present in 43% of ES patients with a median glomerular filtration rate (GFR) of 43.3 ml/min/1.73 m2. CKD was associated with increased all-cause mortality at 3 years (63% vs. 20%; p = 0.001; HR = 4.293; 95% CI 1.874-9.836; p = 0.001) and MACE (57% vs. 30%; p = 0.025; HR = 3.597; 95% CI 1.679-7.708; p = 0.001). In contrast, first cardiac rehospitalization (43% vs. 45%; log-rank p = 0.889) and ES-R (30% vs. 20%; log-rank p = 0.334) were not affected by CKD. Even after multivariable adjustment, CKD was still associated with increased long-term mortality (HR = 2.397; 95% CI 1.012-5.697; p = 0.047), as well as with the secondary endpoint MACE (HR = 2.520; 95% CI 1.109-5.727; p = 0.027).

Conclusions: In patients with ES, the presence of CKD was associated with increased long-term mortality and MACE.

Keywords: Chronic kidney disease; Electrical storm; Long-term mortality; MACE.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig 1
Fig 1
Prognostic impact of CKD on long-term all-cause mortality (left panel) and rehospitalization (right panel) in patients presenting with ES
Fig 2
Fig 2
Prognostic impact of CKD on MACE (left panel) and recurrences of ES (right panel) in patients presenting with ES
See this image and copyright information in PMC

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