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Electrical Storm as an Independent Mortality Risk in Patients with Preserved or Moderately Reduced Left Ventricular Function Results from a Japanese Nationwide Registry
Title: | Electrical Storm as an Independent Mortality Risk in Patients with Preserved or Moderately Reduced Left Ventricular Function Results from a Japanese Nationwide Registry |
Authors: | Watanabe, Masaya Browse this author →KAKEN DB | Yokoshiki, Hisashi Browse this author →KAKEN DB | Noda, Takashi Browse this author | Yokota, Isao Browse this author →KAKEN DB | Nitta, Takashi Browse this author | Aizawa, Yoshifusa Browse this author | Ohe, Tohru Browse this author | Kurita, Takashi Browse this author |
Keywords: | Ventricular tachycardia | Non-ischemic heart disease | Mortality | Implantable cardioverter-defibrillator |
Issue Date: | 29-Nov-2021 |
Publisher: | International Heart Journal Association |
Journal Title: | International heart journal |
Volume: | 62 |
Issue: | 6 |
Start Page: | 1249 |
End Page: | 1256 |
Publisher DOI: | 10.1536/ihj.20-832 |
Abstract: | Electrical storm (ES), defined by 3 or more occurrences of ventricular arrhythmias within 24 hours, has been shown to be associated with an increased risk of mortality; however, detailed information remains lacking. We aimed to examine the incidence and determinants of ES and its impact on mortality in patients enrolled in the nationwide implantable cardioverter-defibrillator (ICD) registry. We studied 1,256 patients (age 65 +/- 12 years) who had structural heart disease with an ICD. The patients were classified into reduced ejection fraction (EF < 35%; 657 (52%) patients) and preserved or moderately reduced EF (EF >= 35%; 599 (48%) patients). ES occurred in 49 (7%) and 36 (6%) patients in the EF < 35% and EF >= 35% groups (log-rank P = 0.297) during the median follow-up of 2.3 years. ICD with resynchronization therapy was associated with a lower incidence of ES in patients with EF < 35%. Non-ischemic heart disease and diuretics were associated with ES in patients with EF >= 35%. During the follow-up, 10/49 (20%) patients with ES and 80/608 patients (13%) without ES died in patients with EF < 35%, while 7/36 (19%) patients with ES and 38/563 patients (7%) without ES died in those with EF >= 35%. We have created 4 Cox multivariate models. All models showed approximately 2-fold higher hazard ratios in patients with EF >= 35% compared to EF < 35%. Our study showed that the determinants of ES differed between EF < 35% and EF >= 35%. The impact of ES for mortality was numerically higher in EF >= 35% than in EF < 35%, although a significant interaction was not detected. |
Type: | article |
URI: | http://hdl.handle.net/2115/84302 |
Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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