European Heart Journal: Acute Cardiovascular Care, 2023, ⟨10.1093/ehjacc/zuad063⟩
Background: 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: 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 centers. The primary endpoint was in-hospital mortality.Results: 45 patients were included (82% men; 55.0 (47.8-59.3) years old; 42.2% and 26.7% non-ischemic dilated or ischemic cardiomyopathies, respectively). Among them, 42 (93.3%) received amiodarone, 29 (64.4%) betablockers; 19 (42.2%) required deep sedation, 22 (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 hemodynamic 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: ES 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.
Raphael Martins, Mathilde Hamel-Bougault, Francis Bessière, Matteo Pozzi, Fabrice Extramiana, et al.. Heart transplantation as a rescue strategy for patients with refractory electrical storm. European Heart Journal: Acute Cardiovascular Care, 2023, ⟨10.1093/ehjacc/zuad063⟩ (lien externe). ⟨hal-04164965⟩ (lien externe)
Citations
APA
Martins, R., Hamel-Bougault, M., Bessière, F., Pozzi, M., Extramiana, F., Brouk, Z., Guenancia, C., Sagnard, A., Ninni, S., Goemine, C., Defaye, P., Boignard, A., Maille, B., Gariboldi, V., Baudinaud, P., Martin, A.-C., Champ-Rigot, L., Blanchart, K., Sellal, J.-M., … Benali, K. (2023). Heart transplantation as a rescue strategy for patients with refractory electrical storm. In European Heart Journal: Acute Cardiovascular Care. https://academic.oup.com/ehjacc/article-pdf/12/9/571/51760651/zuad063.pdf
MLA
Martins, Raphael, et al. “Heart Transplantation as a Rescue Strategy for Patients with Refractory Electrical Storm.” European Heart Journal: Acute Cardiovascular Care, June 2023, https://academic.oup.com/ehjacc/article-pdf/12/9/571/51760651/zuad063.pdf.
Chicago
Martins, Raphael, Mathilde Hamel-Bougault, Francis Bessière, Matteo Pozzi, Fabrice Extramiana, Zohra Brouk, Charles Guenancia, et al. 2023. “Heart Transplantation as a Rescue Strategy for Patients with Refractory Electrical Storm.” European Heart Journal: Acute Cardiovascular Care. https://academic.oup.com/ehjacc/article-pdf/12/9/571/51760651/zuad063.pdf.
Harvard
Martins, R. et al. (2023) “Heart transplantation as a rescue strategy for patients with refractory electrical storm,” European Heart Journal: Acute Cardiovascular Care. Available at: https://academic.oup.com/ehjacc/article-pdf/12/9/571/51760651/zuad063.pdf.
ISO 690
MARTINS, Raphael, 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 and BENALI, Karim, 2023. Heart transplantation as a rescue strategy for patients with refractory electrical storm [en ligne]. June 2023. Disponible à l'adresse : https://academic.oup.com/ehjacc/article-pdf/12/9/571/51760651/zuad063.pdf