Catheter ablation in electrical storm treatment management
Purpose. The purpose of the study was evaluation of early and long-term efficacy of urgent catheter ablation (CA) in patients with ventricular tachyarrhythmias (VTA) and electrical storm (ES). Methods. The study included 30 patients with ES and predominantly secondary prevention of sudden cardiac death (SCD) - 27 (90%). Among them 12 (40%) patients underwent urgent CA after exclusion of reversible causes of ES. The time period between ES and emergency catheter treatment was 1-3 days. The CA procedure included elimination of all possible re-entry zones inside scar and adjacent areas as well as VTA triggers. Results. The efficacy of substrate CA of clinically significant VTA was 58%. The partial effect was observed in 5 patients. Mortality rate in ES was 26,7% (8 of 30 patients) including those after CA. There was no recurrence of ES during follow-up. Conclusions. About 40% of ES patients require emergency CA. This procedure contributes to effective ES elimination during long-term follow-up. Redo CA procedures are performed in 33% of patients with single VTA episodes.