Detail
Article
Online article
FT
Medvik - BMC
  • Something wrong with this record ?

Catheter Ablation of Refractory Ventricular Fibrillation Storm After Myocardial Infarction

Y. Komatsu, M. Hocini, A. Nogami, P. Maury, P. Peichl, YK. Iwasaki, K. Masuda, A. Denis, Q. Voglimacci-Stephanopoli, D. Wichterle, M. Kawamura, S. Fukamizu, Y. Yokoyama, Y. Mukai, T. Harada, K. Yoshida, R. Yasuoka, M. Igawa, K. Ohira, W. Shimizu,...

. 2019 ; 139 (20) : 2315-2325. [pub] 20190514

Language English Country United States

Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc20006497

BACKGROUND: Ventricular fibrillation (VF) storm after myocardial infarction (MI) is a life-threatening condition that necessitates multiple defibrillations. Catheter ablation is a potentially effective treatment strategy for VF storm refractory to optimal medical treatment. However, its impact on patient survival has not been verified in a large population. METHODS: We conducted a multicenter, retrospective observational study involving consecutive patients who underwent catheter ablation of post-MI refractory VF storm without preceding monomorphic ventricular tachycardia. The target of ablation was the Purkinje-related ventricular extrasystoles triggering VF. The primary outcome was in-hospital and long-term mortalities. Univariate logistic regression and Cox proportional-hazards analysis were used to evaluate clinical characteristics associated with in-hospital and long-term mortalities, respectively. RESULTS: One hundred ten patients were enrolled (age, 65±11years; 92 men; left ventricular ejection fraction, 31±10%). VF storm occurred at the acute phase of MI (4.5±2.5 days after the onset of MI during the index hospitalization for MI) in 43 patients (39%), the subacute phase (>1 week) in 48 (44%), and the remote phase (>6 months) in 19 (17%). The focal triggers were found to originate from the scar border zone in 88 patients (80%). During in-hospital stay after ablation, VF storm subsided in 92 patients (84%). Overall, 30 (27%) in-hospital deaths occurred. The duration from the VF occurrence to the ablation procedure was associated with in-hospital mortality (odds ratio for each 1-day increase, 1.11 [95% CI, 1.03-1.20]; P=0.008). During follow-up after discharge from hospital, only 1 patient developed recurrent VF storm. However, 29 patients (36%) died, with a median survival time of 2.2 years (interquartile range, 1.2-5.5 years). Long-term mortality was associated with left ventricular ejection fraction <30% (hazard ratio, 2.54 [95% CI, 1.21-5.32]; P=0.014), New York Heart Association class ≥III (hazard ratio, 2.68 [95% CI, 1.16-6.19]; P=0.021), a history of atrial fibrillation (hazard ratio, 3.89 [95% CI, 1.42-10.67]; P=0.008), and chronic kidney disease (hazard ratio, 2.74 [95% CI, 1.15-6.49]; P=0.023). CONCLUSIONS: In patients with MI presenting with focally triggered VF storm, catheter ablation of culprit triggers is lifesaving and appears to be associated with short- and long-term freedom from recurrent VF storm. Mortality over the long-term follow-up is associated with the severity of underlying cardiovascular disease and comorbidities in this specific patient population.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc20006497
003      
CZ-PrNML
005      
20200525111425.0
007      
ta
008      
200511s2019 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1161/CIRCULATIONAHA.118.037997 $2 doi
035    __
$a (PubMed)30929474
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Komatsu, Yuki $u Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N., K.A., M.I.).
245    10
$a Catheter Ablation of Refractory Ventricular Fibrillation Storm After Myocardial Infarction / $c Y. Komatsu, M. Hocini, A. Nogami, P. Maury, P. Peichl, YK. Iwasaki, K. Masuda, A. Denis, Q. Voglimacci-Stephanopoli, D. Wichterle, M. Kawamura, S. Fukamizu, Y. Yokoyama, Y. Mukai, T. Harada, K. Yoshida, R. Yasuoka, M. Igawa, K. Ohira, W. Shimizu, K. Aonuma, J. Kautzner, M. Haïssaguerre, M. Ieda,
520    9_
$a BACKGROUND: Ventricular fibrillation (VF) storm after myocardial infarction (MI) is a life-threatening condition that necessitates multiple defibrillations. Catheter ablation is a potentially effective treatment strategy for VF storm refractory to optimal medical treatment. However, its impact on patient survival has not been verified in a large population. METHODS: We conducted a multicenter, retrospective observational study involving consecutive patients who underwent catheter ablation of post-MI refractory VF storm without preceding monomorphic ventricular tachycardia. The target of ablation was the Purkinje-related ventricular extrasystoles triggering VF. The primary outcome was in-hospital and long-term mortalities. Univariate logistic regression and Cox proportional-hazards analysis were used to evaluate clinical characteristics associated with in-hospital and long-term mortalities, respectively. RESULTS: One hundred ten patients were enrolled (age, 65±11years; 92 men; left ventricular ejection fraction, 31±10%). VF storm occurred at the acute phase of MI (4.5±2.5 days after the onset of MI during the index hospitalization for MI) in 43 patients (39%), the subacute phase (>1 week) in 48 (44%), and the remote phase (>6 months) in 19 (17%). The focal triggers were found to originate from the scar border zone in 88 patients (80%). During in-hospital stay after ablation, VF storm subsided in 92 patients (84%). Overall, 30 (27%) in-hospital deaths occurred. The duration from the VF occurrence to the ablation procedure was associated with in-hospital mortality (odds ratio for each 1-day increase, 1.11 [95% CI, 1.03-1.20]; P=0.008). During follow-up after discharge from hospital, only 1 patient developed recurrent VF storm. However, 29 patients (36%) died, with a median survival time of 2.2 years (interquartile range, 1.2-5.5 years). Long-term mortality was associated with left ventricular ejection fraction <30% (hazard ratio, 2.54 [95% CI, 1.21-5.32]; P=0.014), New York Heart Association class ≥III (hazard ratio, 2.68 [95% CI, 1.16-6.19]; P=0.021), a history of atrial fibrillation (hazard ratio, 3.89 [95% CI, 1.42-10.67]; P=0.008), and chronic kidney disease (hazard ratio, 2.74 [95% CI, 1.15-6.49]; P=0.023). CONCLUSIONS: In patients with MI presenting with focally triggered VF storm, catheter ablation of culprit triggers is lifesaving and appears to be associated with short- and long-term freedom from recurrent VF storm. Mortality over the long-term follow-up is associated with the severity of underlying cardiovascular disease and comorbidities in this specific patient population.
650    _2
$a senioři $7 D000368
650    _2
$a katetrizační ablace $x metody $7 D017115
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a následné studie $7 D005500
650    _2
$a mortalita v nemocnicích $7 D017052
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a infarkt myokardu $x komplikace $7 D009203
650    _2
$a proporcionální rizikové modely $7 D016016
650    _2
$a Purkyňova vlákna $x patofyziologie $7 D011690
650    _2
$a recidiva $7 D012008
650    _2
$a retrospektivní studie $7 D012189
650    _2
$a tepový objem $7 D013318
650    _2
$a analýza přežití $7 D016019
650    _2
$a výsledek terapie $7 D016896
650    _2
$a fibrilace komor $x etiologie $x mortalita $x patofyziologie $x terapie $7 D014693
650    _2
$a komorové extrasystoly $x komplikace $x patofyziologie $x terapie $7 D018879
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
655    _2
$a pozorovací studie $7 D064888
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Hocini, Mélèze $u Bordeaux University Hospital (Centre Hospitalier Universitaire [CHU]), Electrophysiology and Ablation Unit, Pessac, France (M.H., A.D., M.H.). Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Pessac-Bordeaux, France (M.H., A.D., M.H.). University Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, France (M.H., A.D., M.H.).
700    1_
$a Nogami, Akihiko $u Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N., K.A., M.I.).
700    1_
$a Maury, Philippe $u Hospital Rangueil, Centre Hospitalier Universitaire Toulouse, France (P.M., Q.V.-S.).
700    1_
$a Peichl, Petr $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic (P.P., D.W., J.K.).
700    1_
$a Iwasaki, Yu-Ki $u Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (Y.-k.I., W.S.).
700    1_
$a Masuda, Keita $u Department of Heart Rhythm Management, Yokohama Rosai Hospital, Japan (K.M.).
700    1_
$a Denis, Arnaud $u Bordeaux University Hospital (Centre Hospitalier Universitaire [CHU]), Electrophysiology and Ablation Unit, Pessac, France (M.H., A.D., M.H.). Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Pessac-Bordeaux, France (M.H., A.D., M.H.). University Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, France (M.H., A.D., M.H.).
700    1_
$a Voglimacci-Stephanopoli, Quentin $u Hospital Rangueil, Centre Hospitalier Universitaire Toulouse, France (P.M., Q.V.-S.).
700    1_
$a Wichterle, Dan $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic (P.P., D.W., J.K.).
700    1_
$a Kawamura, Mitsuharu $u Division of Cardiology, Showa University School of Medicine, Tokyo, Japan (M.K.).
700    1_
$a Fukamizu, Seiji $u Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Japan (S.F.).
700    1_
$a Yokoyama, Yasuhiro $u Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan (Y.Y.).
700    1_
$a Mukai, Yasushi $u Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan (Y.M.).
700    1_
$a Harada, Tomoo $u Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan (T.H.).
700    1_
$a Yoshida, Kentaro $u Cardiovascular Division, Ibaraki Prefectural Central Hospital, Kasama, Japan (K.Y.).
700    1_
$a Yasuoka, Ryobun $u Department of Medicine, Faculty of Medicine, Division of Cardiovascular Center, Kinki University School of Medicine, Osaka, Japan (R.Y.).
700    1_
$a Igawa, Masayuki $u Division of Cardiology, Tsukuba Memorial Hospital, Japan (M.I.).
700    1_
$a Ohira, Koji $u Department of Cardiology, Mito Saiseikai General Hospital, Japan (K.O.).
700    1_
$a Shimizu, Wataru $u Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan (Y.-k.I., W.S.).
700    1_
$a Aonuma, Kazutaka $u Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N., K.A., M.I.).
700    1_
$a Kautzner, Josef $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic (P.P., D.W., J.K.).
700    1_
$a Haïssaguerre, Michel $u Bordeaux University Hospital (Centre Hospitalier Universitaire [CHU]), Electrophysiology and Ablation Unit, Pessac, France (M.H., A.D., M.H.). Institut Hospitalo-Universitaire (IHU) Liryc, Electrophysiology and Heart Modeling Institute, Pessac-Bordeaux, France (M.H., A.D., M.H.). University Bordeaux, Centre de Recherche Cardio-thoracique de Bordeaux, France (M.H., A.D., M.H.).
700    1_
$a Ieda, Masaki $u Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N., K.A., M.I.).
773    0_
$w MED00001091 $t Circulation $x 1524-4539 $g Roč. 139, č. 20 (2019), s. 2315-2325
856    41
$u https://pubmed.ncbi.nlm.nih.gov/30929474 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20200511 $b ABA008
991    __
$a 20200525111425 $b ABA008
999    __
$a ok $b bmc $g 1525355 $s 1096553
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2019 $b 139 $c 20 $d 2315-2325 $e 20190514 $i 1524-4539 $m Circulation (New York, N.Y.) $n Circulation (New York) $x MED00001091
LZP    __
$a Pubmed-20200511

Find record

Citation metrics

Archiving options