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Müller, Julian; Behnes, Michael; Ellguth, Dominik; Schupp, Tobias; Taton, Gabriel; Reiser, Linda; Engelke, Niko; Reichelt, Thomas; Bollow, Armin; Kim, Seung-Hyun; Barth, Christian; Rusnak, Jonas; Weidner, Kathrin; Mashayekhi, Kambis; Akin, Muharrem; Bertsch, Thomas; Weiß, Christel; Borggrefe, Martin; Akin, Ibrahim

Prognostic Impact of Atrial Fibrillation in Electrical Storm

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  • Media type: E-Article
  • Title: Prognostic Impact of Atrial Fibrillation in Electrical Storm
  • Contributor: Müller, Julian; Behnes, Michael; Ellguth, Dominik; Schupp, Tobias; Taton, Gabriel; Reiser, Linda; Engelke, Niko; Reichelt, Thomas; Bollow, Armin; Kim, Seung-Hyun; Barth, Christian; Rusnak, Jonas; Weidner, Kathrin; Mashayekhi, Kambis; Akin, Muharrem; Bertsch, Thomas; Weiß, Christel; Borggrefe, Martin; Akin, Ibrahim
  • imprint: S. Karger AG, 2019
  • Published in: Cardiology
  • Language: English
  • DOI: 10.1159/000500262
  • ISSN: 1421-9751; 0008-6312
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Data regarding the prognostic impact of atrial fibrillation (AF) in patients with electrical storm (ES) is rare. &lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; This study sought to assess the prognostic impact of AF in patients with ES on mortality, rehospitalization, major adverse cardiovascular events (MACE) and recurrence of ES (ES-R). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; All consecutive implantable cardioverter defibrillator (ICD) patients presenting with ES were included retrospectively from 2002 to 2016. Patients with AF were compared to non-AF patients. The primary prognostic endpoint was all-cause mortality. Secondary endpoints were in-hospital mortality, rehospitalization rates, MACE and ES-R. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; A total of 87 ES patients with ICD were included and followed up to 2.5 years; 43% suffered from AF. The presence of AF was associated with increased all-cause mortality (47 vs. 29%, log-rank &lt;i&gt;p&lt;/i&gt; = 0.052; hazard ratio [HR] 1.969, 95% confidence interval [CI] 0.981–3.952, &lt;i&gt;p&lt;/i&gt; = 0.057), which was no longer present after multivariable adjustment for age, diabetes and dilated cardiomyopathy. Furthermore, AF was associated with increased rates of overall rehospitalization (61 vs. 31%, log-rank &lt;i&gt;p&lt;/i&gt; = 0.013; HR 2.381, 95% CI 1.247–4.547, &lt;i&gt;p&lt;/i&gt; = 0.009), especially due to AF (14 vs. 0%, &lt;i&gt;p&lt;/i&gt; = 0.001) and acute heart failure (AHF) (28 vs. 10%, &lt;i&gt;p&lt;/i&gt; = 0.018; HR 3.754, 95% CI 1.277–11.038, &lt;i&gt;p&lt;/i&gt; = 0.016). Notably, AF was not associated with differences in MACE (55 vs. 37%, log rank &lt;i&gt;p&lt;/i&gt; = 0.339) and ES-R (28 vs. 25%, log rank &lt;i&gt;p&lt;/i&gt; = 0.704). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; In ES patients, presence of AF was univariably associated with increased rates of all-cause mortality at 2.5 years. Furthermore, AF was multivariably associated with overall rehospitalization, especially due to AF and AHF.</jats:p>