Heart rhythm · 2026
Determinants and outcomes of late electrical storm in patients supported by left ventricular assist device.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cherbi Miloud, Groussin Pierre, Galand Vincent, Flecher Erwan, Bode Kerstin, Efimova Elena, Dashkevich Alexey, Liang Jackson, Larson John, Mondesert Blandine, Boulet Jacinthe, Noly Pierre-Emmanuel, Gautier Paul, Delmas Clément, Martins Raphael
Аннотация
BACKGROUND: Although ventricular arrhythmias (VAs) are frequent after left ventricular assist device (LVAD) implantation, the characteristics and prognostic significance of late electrical storm (ES) remain incompletely understood.
OBJECTIVE: This study aimed to assess the incidence and clinical impact of late ES in LVAD recipients.
METHODS: This international, multicenter, retrospective study included 1151 LVAD recipients implanted between 2006 and 2019. Late ES was defined as ≥ 3 sustained VA episodes within 24 hours occurring beyond 30 days after implantation. The primary outcome was 5-year all-cause mortality. The secondary endpoint was 5-year cardiac mortality.
RESULTS: Late ES occurred in 49 patients (4.3%), with a median onset at 9.2 months after implantation. Patients with late ES experienced significantly higher 5-year all-cause mortality (adjusted hazard ratio [aHR] 2.87 [1.81-4.54]; P < .01) and cardiac mortality (aHR 3.47 [2.14-5.62]; P < .01). Notably, late VA without ES showed no prognostic impact. Multivariable analysis identified 4 independent predictors of late ES: left ventricular end-diastolic diameter of ≥80 mm before LVAD implantation (aHR 2.47 [1.29-4.87]), nonischemic cardiomyopathy (aHR 2.20 [1.10-4.40]), history of VAs (aHR 2.35 [1.27-4.32]), and implantable cardioverter-defibrillator before LVAD implantation (aHR 4.80 [1.12-20.85]). The late ES-LVAD score, based on these variables, demonstrated good discrimination (C-statistic 0.76) and stratified patients into low- (score 0-1), intermediate- (score 2-3), and high-risk groups (score 4-5), with corresponding late ES rates of 1.0%, 3.9%, and 7.8%.
CONCLUSION: Late ES, but not isolated late VAs, is independently associated with substantially worse long-term outcomes in LVAD recipients. The late ES-LVAD score enables practical risk stratification, facilitating targeted therapeutic interventions in high-risk patients.
OBJECTIVE: This study aimed to assess the incidence and clinical impact of late ES in LVAD recipients.
METHODS: This international, multicenter, retrospective study included 1151 LVAD recipients implanted between 2006 and 2019. Late ES was defined as ≥ 3 sustained VA episodes within 24 hours occurring beyond 30 days after implantation. The primary outcome was 5-year all-cause mortality. The secondary endpoint was 5-year cardiac mortality.
RESULTS: Late ES occurred in 49 patients (4.3%), with a median onset at 9.2 months after implantation. Patients with late ES experienced significantly higher 5-year all-cause mortality (adjusted hazard ratio [aHR] 2.87 [1.81-4.54]; P < .01) and cardiac mortality (aHR 3.47 [2.14-5.62]; P < .01). Notably, late VA without ES showed no prognostic impact. Multivariable analysis identified 4 independent predictors of late ES: left ventricular end-diastolic diameter of ≥80 mm before LVAD implantation (aHR 2.47 [1.29-4.87]), nonischemic cardiomyopathy (aHR 2.20 [1.10-4.40]), history of VAs (aHR 2.35 [1.27-4.32]), and implantable cardioverter-defibrillator before LVAD implantation (aHR 4.80 [1.12-20.85]). The late ES-LVAD score, based on these variables, demonstrated good discrimination (C-statistic 0.76) and stratified patients into low- (score 0-1), intermediate- (score 2-3), and high-risk groups (score 4-5), with corresponding late ES rates of 1.0%, 3.9%, and 7.8%.
CONCLUSION: Late ES, but not isolated late VAs, is independently associated with substantially worse long-term outcomes in LVAD recipients. The late ES-LVAD score enables practical risk stratification, facilitating targeted therapeutic interventions in high-risk patients.