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Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial.

Publication ,  Journal Article
Hohnloser, SH; Al-Khalidi, HR; Pratt, CM; Brum, JM; Tatla, DS; Tchou, P; Dorian, P ...
Published in: Eur Heart J
December 2006

AIMS: The purpose of this study was to assess the incidence, features, and clinical sequelae of 'electrical storm' (ES). METHODS AND RESULTS: This study is a prospectively designed secondary analysis of SHIELD; a randomized trial of azimilide for suppression of ventricular tachycardia/fibrillation (VT/VF) leading to implanted cardioverter defibrillator (ICD) therapies. Systematic and rigorous follow-up and blinded adjudication of ICD therapy allowed identification of all ESs (>/=3 separate VT/VF episodes leading to ICD therapies within 24 h). Of 633 ICD recipients, 148 (23%) experienced at least one ES over 1-year follow-up. No clinical predictors of ES were identified. Frequent VT episodes accounted for 91% of all ESs, with the remaining being VF alone or both VT plus VF. ES led to a 3.1-fold increase in arrhythmia-related hospitalization (95% CI 2.3-4.3; P<0.0001) compared with patients with isolated VT/VF, and to a 10.2-fold increase (95% CI 6.4-16.3; P<0.0001) compared with patients without VT/VF. Compared with placebo, azimilide (75 and 125 mg/day) reduced the risk of recurrent ES by 37% (HR=0.63, 95% CI 0.35-1.11, P=0.11) and 55% (HR=0.45, 95% CI 0.23-0.87, P=0.018), respectively. However, the reduction in time-to-first ES did not reach statistical significance by both doses (75 and 125 mg) of azimilide (HR=0.82, 95% CI 0.56-1.19, P=0.29 and HR=0.69, 95% CI 0.46-1.04, P=0.07), respectively. CONCLUSION: ES is common and unpredictable in ICD recipients and it is a strong predictor of hospitalization.

Duke Scholars

Published In

Eur Heart J

DOI

ISSN

0195-668X

Publication Date

December 2006

Volume

27

Issue

24

Start / End Page

3027 / 3032

Location

England

Related Subject Headings

  • Treatment Outcome
  • Tachycardia, Ventricular
  • Prospective Studies
  • Piperazines
  • Middle Aged
  • Male
  • Imidazolidines
  • Hydantoins
  • Humans
  • Female
 

Citation

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Hohnloser, S. H., Al-Khalidi, H. R., Pratt, C. M., Brum, J. M., Tatla, D. S., Tchou, P., … SHock Inhibition Evaluation with AzimiLiDe (SHIELD) Investigators, . (2006). Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. Eur Heart J, 27(24), 3027–3032. https://doi.org/10.1093/eurheartj/ehl276
Hohnloser, Stefan H., Hussein R. Al-Khalidi, Craig M. Pratt, Jose M. Brum, Daljit S. Tatla, Patrick Tchou, Paul Dorian, and Paul SHock Inhibition Evaluation with AzimiLiDe (SHIELD) Investigators. “Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial.Eur Heart J 27, no. 24 (December 2006): 3027–32. https://doi.org/10.1093/eurheartj/ehl276.
Hohnloser SH, Al-Khalidi HR, Pratt CM, Brum JM, Tatla DS, Tchou P, et al. Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. Eur Heart J. 2006 Dec;27(24):3027–32.
Hohnloser, Stefan H., et al. “Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial.Eur Heart J, vol. 27, no. 24, Dec. 2006, pp. 3027–32. Pubmed, doi:10.1093/eurheartj/ehl276.
Hohnloser SH, Al-Khalidi HR, Pratt CM, Brum JM, Tatla DS, Tchou P, Dorian P, SHock Inhibition Evaluation with AzimiLiDe (SHIELD) Investigators. Electrical storm in patients with an implantable defibrillator: incidence, features, and preventive therapy: insights from a randomized trial. Eur Heart J. 2006 Dec;27(24):3027–3032.
Journal cover image

Published In

Eur Heart J

DOI

ISSN

0195-668X

Publication Date

December 2006

Volume

27

Issue

24

Start / End Page

3027 / 3032

Location

England

Related Subject Headings

  • Treatment Outcome
  • Tachycardia, Ventricular
  • Prospective Studies
  • Piperazines
  • Middle Aged
  • Male
  • Imidazolidines
  • Hydantoins
  • Humans
  • Female