Author + information
- Received November 25, 2019
- Revision received April 22, 2020
- Accepted April 27, 2020
- Published online June 24, 2020.
- Maria Lícia Ribeiro Cury Pavão, MDa,
- Elerson Arfelli, MD, PhDa,
- Adilson Scorzoni-Filho, MD, PhDb,
- Rafael Brolio Pavão, MD, PhDa,
- Antonio Pazin-Filho, MD, PhDa,
- José Antonio Marin-Neto, MD PhDa and
- André Schmidt, MD, PhDa,∗ ()
- aCardiology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- bSurgical Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- ↵∗Address for correspondence:
Dr. André Schmidt, Cardiology Division, Internal Medicine Department, Ribeirão Preto Medical School, Avenue Bandeirantes 3900, Monte Alegre, Ribeirão Preto-SP, Brazil 14048–900.
Objectives In this study of patients with Chagas heart disease (CHD) with an implantable cardioverter defibrillator (ICD) for secondary prevention of sudden cardiac death, we sought to compare the characteristics of those with or without electrical storm (ES) during long-term follow-up.
Background ES is a common problem in patients with CHD harboring an ICD, but data on clinical predictors and outcomes are limited.
Methods We retrospectively evaluated 110 patients with CHD with a mean follow-up of 1949 ± 1271 days. Demographic, clinical, arrhythmia characteristics, ICD treatment, and death data were collected. Descriptive statistics included mean ± SD and Fisher exact tests used for comparisons. A p-value <0.05 was considered significant.
Results The ES group (57 patients; 43 men; 62 ± 10 years) and the non-ES group (53 patients; 43 men; 57 ± 14 years) had similar baseline demographic and clinical parameters, but left ventricular ejection fraction was higher in the ES group (44% ± 14% vs. 37% ± 14%, p = 0.02) and QRS duration was shorter (109 ± 35 ms vs. 134 ± 36 ms; p = 0.0027). Mortality rates were comparable in the 2 groups (odds ratio: 1.2; 95% confidence interval: 0.79 to 1.85; p = 0.44). The ES group presented 116 ES (2.03 ±1.47, 1 to 6). A total of 2,953 (61%) arrhythmic events required ICD therapy. No deaths occurred directly caused by ES, but clinical triggers were reported in 20 patients.
Conclusions ES is frequent in CHD but in itself does not carry a worse prognosis in this study population and was not associated with a more depressed left ventricular systolic function or a longer QRS.
This research was partly funded by a grant received by Dr. Marin-Neto from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) - 2016/25403–9. The authors have reported that they no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received November 25, 2019.
- Revision received April 22, 2020.
- Accepted April 27, 2020.
- 2020 American College of Cardiology Foundation
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