Academic Journal
Early catheter ablation in electrical storm: a propensity score-matched comparison with medical therapy
| Τίτλος: | Early catheter ablation in electrical storm: a propensity score-matched comparison with medical therapy |
|---|---|
| Συγγραφείς: | Carvalho, R, Certo Pereira, J, Barbosa Sousa, R, Bello, A R, Gomes, D, Presume, J, Matos, D, Strong, C, Laranjeira, T, Moscoso Costa, F, Galvao Santos, P, Carmo, P, Cavaco, D, Brizido, C, Adragao, P |
| Πηγή: | Europace ; volume 28, issue Supplement_1 ; ISSN 1099-5129 1532-2092 |
| Στοιχεία εκδότη: | Oxford University Press (OUP) |
| Έτος έκδοσης: | 2026 |
| Περιγραφή: | Background Electrical storm (ES) is a life-threatening arrhythmic emergency, whose initial management relies on antiarrhythmic therapy, beta-blockers, sedation, and hemodynamic support. Early catheter ablation (CA) has been proposed as a strategy to improve outcomes. This study aimed to compare CA with medical therapy alone in patients experiencing a first ES episode. Methods Single-center, retrospective study including consecutive patients admitted to the cardiac intensive care unit (CICU) between 2015 and 2025 with a first ES episode, defined as ≥3 episodes of sustained ventricular arrhythmia within 24 hours. Patients were categorized according to management strategy (medical therapy or CA performed during the index hospitalization) and subsequently matched 1:1 based on age, left ventricular ejection fraction (LVEF), PAINESD score, creatinine, NT-proBNP, presence of a trigger, and the use of sedation, mechanical ventilation, and vasoactive drugs. In the matched cohort, Cox regression was used to estimate hazard ratios (HRs) for time-to-event outcomes: ventricular tachycardia (VT) recurrence and cardiovascular (CV) mortality during follow-up (FUP). Results A total of 127 patients were included (age 65±14 years; 88% male): 69 (54%) underwent CA and 58 (46%) received medical therapy. The majority had ischemic structural heart disease (59%), followed by non-ischemic cardiomyopathy (39%); 88% presented with monomorphic VT. Patients managed medically presented more frequently with acute myocardial infarction (22% vs. 3%, p<0.001), out-of-hospital cardiac arrest (12% vs. 1%, p=0.023), and identifiable triggers (47% vs. 13%, p<0.001). During hospitalization, 33% required continuous sedation, 30% mechanical ventilation, and 26% vasoactive support. Compared with medical therapy, CA patients required less sedation (25% vs. 43%, p=0.044), mechanical ventilation (19% vs. 43%, p=0.005), and vasoactive drugs (17% vs. 36%, p=0.027), suggesting greater early clinical stability. Time to CA was 5 days ... |
| Τύπος εγγράφου: | article in journal/newspaper |
| Γλώσσα: | English |
| DOI: | 10.1093/europace/euag105.1108 |
| Διαθεσιμότητα: | https://doi.org/10.1093/europace/euag105.1108 https://academic.oup.com/europace/article-pdf/28/Supplement_1/euag105.1108/68619422/euag105.1108.pdf |
| Rights: | https://creativecommons.org/licenses/by-nc/4.0/ |
| Αριθμός Καταχώρησης: | edsbas.6E88D4A6 |
| Βάση Δεδομένων: | BASE |
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