In:
Cardiology, S. Karger AG, Vol. 144, No. 1-2 ( 2019), p. 9-17
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Data regarding the prognostic impact of atrial fibrillation (AF) in patients with electrical storm (ES) is rare. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 This study sought to assess the prognostic impact of AF in patients with ES on mortality, rehospitalization, major adverse cardiovascular events (MACE) and recurrence of ES (ES-R). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 All consecutive implantable cardioverter defibrillator (ICD) patients presenting with ES were included retrospectively from 2002 to 2016. Patients with AF were compared to non-AF patients. The primary prognostic endpoint was all-cause mortality. Secondary endpoints were in-hospital mortality, rehospitalization rates, MACE and ES-R. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 87 ES patients with ICD were included and followed up to 2.5 years; 43% suffered from AF. The presence of AF was associated with increased all-cause mortality (47 vs. 29%, log-rank 〈 i 〉 p 〈 /i 〉 = 0.052; hazard ratio [HR] 1.969, 95% confidence interval [CI] 0.981–3.952, 〈 i 〉 p 〈 /i 〉 = 0.057), which was no longer present after multivariable adjustment for age, diabetes and dilated cardiomyopathy. Furthermore, AF was associated with increased rates of overall rehospitalization (61 vs. 31%, log-rank 〈 i 〉 p 〈 /i 〉 = 0.013; HR 2.381, 95% CI 1.247–4.547, 〈 i 〉 p 〈 /i 〉 = 0.009), especially due to AF (14 vs. 0%, 〈 i 〉 p 〈 /i 〉 = 0.001) and acute heart failure (AHF) (28 vs. 10%, 〈 i 〉 p 〈 /i 〉 = 0.018; HR 3.754, 95% CI 1.277–11.038, 〈 i 〉 p 〈 /i 〉 = 0.016). Notably, AF was not associated with differences in MACE (55 vs. 37%, log rank 〈 i 〉 p 〈 /i 〉 = 0.339) and ES-R (28 vs. 25%, log rank 〈 i 〉 p 〈 /i 〉 = 0.704). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In ES patients, presence of AF was univariably associated with increased rates of all-cause mortality at 2.5 years. Furthermore, AF was multivariably associated with overall rehospitalization, especially due to AF and AHF.
Type of Medium:
Online Resource
ISSN:
0008-6312
,
1421-9751
Language:
English
Publisher:
S. Karger AG
Publication Date:
2019
detail.hit.zdb_id:
1482041-9
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