Heart failure & cardiomyopathies

Clinical Impact and Prediction of Early Electrical Storm in Patients With Left Ventricular Assist Device

JACC Clin ElectrophysiolPublished international, multicenter, retrospective study

Main finding · 3-month all-cause mortalityResult — go to the resultAdjusted hazard ratio 3.09 95% CI 1.91–5.01

Authors' conclusion

Early ES, but not isolated early VAs, is associated with substantially worse outcomes in LVAD recipients. The EarlyES-LVAD score enables practical risk stratification, facilitating targeted therapeutic interventions in high-risk patients.

Study context

Population
Recipients of left ventricular assist device (LVADs) implanted between 2006 and 2019
Participants
1,309 LVAD recipients
Exposure
Patients with early electrical storm (ES) vs without early ES
  • Early ESn = 56
Outcome
3-month all-cause mortality
Follow-up
3 months

Main finding

As reported in the abstract

Adjusted hazard ratio

3.09

95% CI 1.91–5.01

P < 0.01

Patients with early ESvs without early ES
aHR 3.09 (95% CI 1.91–5.01); P < 0.01

Observational data: associations, not effects.

Secondary outcomes

Early right ventricular (RV) failure · ≤30 days

aHR (95% CI)P value
Early ES2.05 (1.10–3.92)P = 0.03

Early ES rate

OutcomeLow-risk (score 0-1)Intermediate-risk (score 2-3)High-risk (score 4-6)
EarlyES-LVAD score performance1.1%3.9%12.4%
EarlyES-LVAD score performance — C-statistic
0.75

Incidence of early ES

Early ES occurred
56 patients (4.3%)
Median onset postimplantation
5 days

Early VA without ES

No prognostic impact

Independent predictors of early ES (multivariable analysis)

pre-LVAD RV S' wave ≤9.5 cm/s, aHR (95% CI)
2.25 (1.23-4.14)
Heart failure duration of ≥5 years, aHR (95% CI)
2.41 (1.10-5.28)
History of ventricular arrhythmias (VAs), aHR (95% CI)
4.43 (2.21-8.87)
Prior mechanical circulatory support, aHR (95% CI)
6.40 (2.12-19.33)

Original publication

Clinical Impact and Prediction of Early Electrical Storm in Patients With Left Ventricular Assist Device. JACC Clin Electrophysiol. Published 14 March 2026. doi:10.1016/j.jacep.2026.01.050

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