Heart failure & cardiomyopathiesCohort study
Clinical Impact and Prediction of Early Electrical Storm in Patients With Left Ventricular Assist Device
- international, multicenter, retrospective study
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 ES vs 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
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Early ES · increased with early ES | 2.05 (1.10–3.92) | P = 0.03 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| EarlyES-LVAD score performance | low-risk (score 0-1) early ES rate 1.1% · intermediate-risk (score 2-3) early ES rate 3.9% · high-risk (score 4-6) early ES rate 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
Summarised from the published abstract; every number is checked against it