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Catheter ablation of ventricular tachycardia in patients with electrical storm, with a special focus on patients with Chagas disease

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Abstract

Background

There are few reports on the benefits of catheter ablation (CA) in patients with electrical storm (ES). None of these publications included patients with Chagas disease (ChD). Our aims are to analyze (1) all the cases of ES treated with CA and (2) the subgroup of patients with ChD.

Methods

Prospective analysis of consecutive patients with ES due to monomorphic ventricular tachycardia (VT) treated with CA.

Results

We included 38 patients: 28 males; median age of 63.5 (IQR 55–71) years old; ejection fraction (LVEF) 0.30 (0.25–0.40). Sixteen patients (42.1%) had ChD. The patients experienced 21 (15–37) VT episodes and received 7 (3–13) ICD shocks before CA. Forty-six procedures were performed (7 required epicardial access). All patients experienced ES suppression after CA. After 35 (10–64) months of follow-up (1.21 procedures per patient), 23 patients (60.5%) remain free from any VT; 35 patients (92.1%) were free from ES, and 11 patients (28.9%) died from non-arrhythmic causes. One patient underwent heart transplantation. Patients with ChD were younger (60 vs. 67 years old; p = 0.033), significantly more women (50% vs. 9.1%; p = 0.005), and had higher LVEF (0.40 vs. 0.28; p < 0.001) than the other patients. Long-term outcome of ChD patients was similar to that of the overall population. Only age and LVEF independently predicted mortality.

Conclusion

CA was associated with acute ventricular arrhythmia suppression in all patients with ES. Freedom rates from ES and VT were 92.1% and 60.5% respectively. Despite having a lower-risk clinical profile, patients with ChD had a comparable outcome to that of the other patients.

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Data availability

The data underlying this article will be shared on a reasonable request to the corresponding author.

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Authors and Affiliations

  1. Hospital General de Agudos Cosme Argerich, Pi y Margall 750, 1155, Buenos Aires, Argentina

    Claudio Hadid, Darío Di Toro, Leonardo Celano, Edgar Antezana-Chaves & Carlos Labadet

  2. Hospital Universitario CEMIC, Buenos Aires, Argentina

    Claudio Hadid, Darío Di Toro, Leonardo Celano, Edgar Antezana-Chaves & Carlos Labadet

  3. Clinica y Maternidad Suizo-Argentina, Buenos Aires, Argentina

    Claudio Hadid, Nicolas Martinenghi & Sergio Dubner

  4. Instituto Médico Quirúrgico Garat, Concordia, Entre Rios, Argentina

    Claudio Hadid & Sebastian Gallino

Authors
  1. Claudio Hadid
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  2. Darío Di Toro
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  3. Leonardo Celano
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  5. Edgar Antezana-Chaves
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  8. Carlos Labadet
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Correspondence to Claudio Hadid.

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The authors declare that they have no conflict of interest.

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The study protocol was assessed and approved by the Institutional Review Committees.

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Claudio Hadid, Sergio Dubner, and Carlos Labadet are Member of LAHRS.

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Hadid, C., Di Toro, D., Celano, L. et al. Catheter ablation of ventricular tachycardia in patients with electrical storm, with a special focus on patients with Chagas disease. J Interv Card Electrophysiol 62, 557–564 (2021). https://doi.org/10.1007/s10840-020-00915-7

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  • DOI: https://doi.org/10.1007/s10840-020-00915-7

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