Characteristics and Outcomes in Patients With Electrical Storm.

Electrical storm (ES) is a life-threatening condition with diverse clinical presentation, caused by recurrent malignant ventricular arrhythmia--≥3 episodes of ventricular tachycardia (VT) or ventricular fibrillation within 24hours and is associated with high mortality. The aim of this study was analysis of clinical profile, treatment, and prognosis of patients with ES admitted to a high-volume cardiovascular center. We present results of a single-center, retrospective, ongoing observational registry enrolling consecutive patients presenting with ES admitted between 2006 and 2017. Clinical history, results of diagnostic investigations, and treatment were collected for all patients. Follow-up data were collected from hospital documentation, outpatient clinic, remote monitoring systems, and from data gathered from national health services. Registry enrolled 101 consecutive patients admitted with ES. Two-thirds of patients had ischemic cardiomyopathy. Mean left ventricle ejection fraction was 26%. In 56.4% of the patients coronary angiogram was performed and in 20.8% cases percutaneous coronary intervention was needed. 18.8% of the patients underwent VT ablation. 12-month mortality from first ES in our population was 21.8%. NYHA class III and IV, raised N-terminal fragment of prohormone B-type Natriuretic Peptide and creatinine levels, and lower hemoglobin levels were independent predictors of death. In conclusion, most patients admitted with ES have ischemic cardiomyopathy. Over 1/3 of the population had significant narrowing of at least one coronary artery with ES masking ischemia and underwent percutaneous coronary intervention. Nearly 1/5 of the patients were treated with VT ablation. 12-month mortality was high and exceeded 1/4 of patients with ES.