Impact of Catheter Ablation of Electrical Storm on Survival: A Propensity Score-Matched Analysis.
JACC Clin Electrophysiol
; 2024 Jul 17.
Article
in En
| MEDLINE
| ID: mdl-39093275
ABSTRACT
BACKGROUND:
Electrical storm (ES) is a life-threatening condition, associated with substantial early and subacute mortality. Catheter ablation (CA) is a well-established therapy for ES. However, data regarding the impact of CA on the short-term and midterm survival of patients admitted for ES remain unclear.OBJECTIVES:
This multicenter study aimed to investigate the impact of CA of ES on survival outcomes, while accounting for key patient characteristics associated with treatment selection.METHODS:
A propensity score-matching (PSM) analysis was performed on 780 consecutive patients admitted for ES in 4 tertiary centers. PSM (11) based on the main characteristics associated with the use of CA or medical therapy alone was performed, resulting in 2 groups of 288 patients.RESULTS:
After PSM, patients who underwent CA (n = 288) and those treated with medical therapy alone (n = 288) did not present any significant differences in the main demographic characteristics, ES presentation, and management. Compared with medical therapy alone, CA was associated with a significantly lower rate of ES recurrence at 1 year (5% vs 26%; P < 0.001). Similarly, CA was associated with a higher 1-year (91% vs 81%; P < 0.001) and 3-year (78% vs 71%; P = 0.017) survival after discharge. In subgroup analyses, effect of ablation therapy remained consistent in patients older than 70 years of age (HR 0.39; 95% CI 0.24-0.66), with substantial efficacy in patients with a LVEF <35% (HR 0.39; 95% CI 0.27-0.59).CONCLUSIONS:
In propensity-matched analyses, this large study shows that CA-based management of patients admitted for ES is associated with a reduction in mortality compared with medical treatment, particularly in patients with a low ejection fraction.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
JACC Clin Electrophysiol
/
JACC Clin. Electrophysiol
/
JACC. Clinical electrophysiology (Online)
Year:
2024
Document type:
Article
Country of publication:
United States