دورية أكاديمية
Heart transplantation as a rescue strategy for patients with refractory electrical storm
| العنوان: | Heart transplantation as a rescue strategy for patients with refractory electrical storm |
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| المؤلفون: | Martins, Raphael P, Hamel-Bougault, Mathilde, Bessière, Francis, Pozzi, Matteo, Extramiana, Fabrice, Brouk, Zohra, Guenancia, Charles, Sagnard, Audrey, Ninni, Sandro, Goemine, Céline, Defaye, Pascal, Boignard, Aude, Maille, Baptiste, Gariboldi, Vlad, Baudinaud, Pierre, Martin, Anne-Céline, Champ-Rigot, Laure, Blanchart, Katrien, Sellal, Jean-Marc, De Chillou, Christian, Dyrda, Katia, Jesel-Morel, Laurence, Kindo, Michel, Chaumont, Corentin, Anselme, Frédéric, Delmas, Clément, Maury, Philippe, Arnaud, Marine, Flecher, Erwan, Benali, Karim |
| المساهمون: | French Group of Pacing and Electrophysiology |
| المصدر: | European Heart Journal: Acute Cardiovascular Care ; volume 12, issue 9, page 571-581 ; ISSN 2048-8726 2048-8734 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, General Medicine |
| الوصف: | Aims Heart transplantation (HT) can be proposed as a therapeutic strategy for patients with severe refractory electrical storm (ES). Data in the literature are scarce and based on case reports. We aimed at determining the characteristics and survival of patients transplanted for refractory ES. Methods and results Patients registered on HT waiting list during the following days after ES and eventually transplanted, from 2010 to 2021, were retrospectively included in 11 French centres. The primary endpoint was in-hospital mortality. Forty-five patients were included [82% men; 55.0 (47.8–59.3) years old; 42.2% and 26.7% non-ischaemic dilated or ischaemic cardiomyopathies, respectively]. Among them, 42 (93.3%) received amiodarone, 29 received (64.4%) beta blockers, 19 (42.2%) required deep sedation, 22 had (48.9%) mechanical circulatory support, and 9 (20.0%) had radiofrequency catheter ablation. Twenty-two patients (62%) were in cardiogenic shock. Inscription on wait list and transplantation occurred 3.0 (1.0–5.0) days and 9.0 (4.0–14.0) days after ES onset, respectively. After transplantation, 20 patients (44.4%) needed immediate haemodynamic support by extracorporeal membrane oxygenation (ECMO). In-hospital mortality rate was 28.9%. Predictors of in-hospital mortality were serum creatinine/urea levels, need for immediate post-operative ECMO support, post-operative complications, and surgical re-interventions. One-year survival was 68.9%. Conclusion Electrical storm is a rare indication of HT but may be lifesaving in those patients presenting intractable arrhythmias despite usual care. Most patients can be safely discharged from hospital, although post-operative mortality remains substantial in this context of emergency transplantation. Larger studies are warranted to precisely determine those patients at higher risk of in-hospital mortality. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/ehjacc/zuad063 |
| DOI: | 10.1093/ehjacc/zuad063/50844192/zuad063.pdf |
| الإتاحة: | https://doi.org/10.1093/ehjacc/zuad063Test https://academic.oup.com/ehjacc/article-pdf/12/9/571/51760651/zuad063.pdfTest |
| حقوق: | https://academic.oup.com/pages/standard-publication-reuse-rightsTest |
| رقم الانضمام: | edsbas.259E1173 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/ehjacc/zuad063 |
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