Heart failure & cardiomyopathiesCohort study
Determinants and outcomes of late electrical storm in patients supported by left ventricular assist device
- international, multicenter, retrospective study
Authors' conclusion
Late ES, but not isolated late VAs, is independently associated with substantially worse long-term outcomes in LVAD recipients. The late ES-LVAD score enables practical risk stratification, facilitating targeted therapeutic interventions in high-risk patients.
Study context
- Population
- Left ventricular assist device (LVAD) recipients implanted between 2006 and 2019
- Participants
- 1,151 LVAD recipients
- Exposure
- Patients with late electrical storm (ES) vs those without
- late ESn = 49
- Outcome
- 5-year all-cause mortality
- Follow-up
- 5 years
Main finding
As reported in the abstract
Adjusted hazard ratio
2.87
CI 1.81–4.54
P < 0.01
Patients with late ES vs those without
aHR 2.87 (CI 1.81–4.54); P < 0.01
Observational data: associations, not effects.
Secondary outcomes
5-year cardiac mortality (secondary endpoint)
| Comparison | aHR (CI) | P value | |
|---|---|---|---|
| late ES · higher with late ES | 3.47 (2.14–5.62) | P < 0.01 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Late ES-LVAD score performance | low-risk (score 0-1) late ES rate 1.0% · intermediate-risk (score 2-3) late ES rate 3.9% · high-risk (score 4-5) late ES rate 7.8% |
- Late ES-LVAD score performance — C-statistic
- 0.76
Incidence of late ES
- Late ES
- 49 patients (4.3%)
- Median onset after implantation
- 9.2 months
Prognostic impact of late VA without ES
- late VA without ES showed no prognostic impact
Independent predictors of late ES (multivariable analysis)
- left ventricular end-diastolic diameter of ≥80 mm before LVAD implantation, aHR
- 2.47 [1.29-4.87]
- nonischemic cardiomyopathy, aHR
- 2.20 [1.10-4.40]
- history of ventricular arrhythmias (VAs), aHR
- 2.35 [1.27-4.32]
- implantable cardioverter-defibrillator before LVAD implantation, aHR
- 4.80 [1.12-20.85]
Original publication
Determinants and outcomes of late electrical storm in patients supported by left ventricular assist device. Heart Rhythm. Published 30 May 2026. doi:10.1016/j.hrthm.2026.05.046
Summarised from the published abstract; every number is checked against it