open access

Vol 69, No 7 (2011)
Original articles
Published online: 2011-07-18
Submitted: 2012-12-28
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Efficacy of catheter ablation in patients with an electrical storm

Edward Koźluk, Sylwia Gaj, Marek Kiliszek, Piotr Lodziński, Agnieszka Piątkowska, Grzegorz Opolski
Kardiol Pol 2011;69(7):665-670.

open access

Vol 69, No 7 (2011)
Original articles
Published online: 2011-07-18
Submitted: 2012-12-28

Abstract

Background: Electrical storm (ES) is a life-threating condition requiring prompt and effective therapy. This may be achieved by the use of catheter ablation.
Aim: To assess safety and efficacy of catheter ablation in patients with ES.
Methods: We performed 28 ablation procedures from February 2006 to May 2010 due to ES in 24 patients (21 men, 3 women, aged 62.5 ± 7.8 years). Eighteen patients had a history of myocardial infarction, 2 — dilated cardiomyopathy, 2 — hypertrophic cardiomyopathy (one also had myocardial infarction), 1 — spongiform cardiomyopathy, 1 — heart failure after aortic valve replacement and 1 — myocarditis. The mean value of ejection fraction was 27.3 ± 6.5% (15–40%). Procedures were performed using the CARTO system. Two patients after an endocardial map had also epicardial mapping performed and one of these patients underwent epicardial cryoablation. The other one underwent a radiofrequency catheter ablation.
Results: During the follow-up period of 27.8 ± 15.9 months 16 (66%) patients had no ventricular tachycardia (VT)/ventricular fibrillation (VF) episodes. Sporadic VT episodes were observed in 3 patients. Recurrence of ES occurred in 3 (12%) patients and 3 (12%) patients died during the follow-up due to the progresion of heart failure.
Conclusions: 1. Ablation of ventricular arrhythmias in the course of ES in patients with organic heart disease is safe and effective, and probably improves their prognosis. 2. After ablation, some patients have adequate interventions of implantable cardioverter-defibrillator due to progression of the disease. 3. The method does not prevent haemodynamic mortality.
Kardiol Pol 2011; 69, 7: 665–670

Abstract

Background: Electrical storm (ES) is a life-threating condition requiring prompt and effective therapy. This may be achieved by the use of catheter ablation.
Aim: To assess safety and efficacy of catheter ablation in patients with ES.
Methods: We performed 28 ablation procedures from February 2006 to May 2010 due to ES in 24 patients (21 men, 3 women, aged 62.5 ± 7.8 years). Eighteen patients had a history of myocardial infarction, 2 — dilated cardiomyopathy, 2 — hypertrophic cardiomyopathy (one also had myocardial infarction), 1 — spongiform cardiomyopathy, 1 — heart failure after aortic valve replacement and 1 — myocarditis. The mean value of ejection fraction was 27.3 ± 6.5% (15–40%). Procedures were performed using the CARTO system. Two patients after an endocardial map had also epicardial mapping performed and one of these patients underwent epicardial cryoablation. The other one underwent a radiofrequency catheter ablation.
Results: During the follow-up period of 27.8 ± 15.9 months 16 (66%) patients had no ventricular tachycardia (VT)/ventricular fibrillation (VF) episodes. Sporadic VT episodes were observed in 3 patients. Recurrence of ES occurred in 3 (12%) patients and 3 (12%) patients died during the follow-up due to the progresion of heart failure.
Conclusions: 1. Ablation of ventricular arrhythmias in the course of ES in patients with organic heart disease is safe and effective, and probably improves their prognosis. 2. After ablation, some patients have adequate interventions of implantable cardioverter-defibrillator due to progression of the disease. 3. The method does not prevent haemodynamic mortality.
Kardiol Pol 2011; 69, 7: 665–670
Get Citation

Keywords

electrical storm; radiofrequency catheter ablation; cryoablation; epicardial ablation; ventricular tachycardia; ventricular fibrillation

About this article
Title

Efficacy of catheter ablation in patients with an electrical storm

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 69, No 7 (2011)

Pages

665-670

Published online

2011-07-18

Bibliographic record

Kardiol Pol 2011;69(7):665-670.

Keywords

electrical storm
radiofrequency catheter ablation
cryoablation
epicardial ablation
ventricular tachycardia
ventricular fibrillation

Authors

Edward Koźluk
Sylwia Gaj
Marek Kiliszek
Piotr Lodziński
Agnieszka Piątkowska
Grzegorz Opolski

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