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(Circulation. 2008;117:453-455.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Catheter Ablation for the Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillators: Short- and Long-Term Outcomes in a Prospective Single-Center Study

 
Multiple shocks resulting from repetitive episodes of ventricular tachycardia, known as electrical storm (ES), occur in 10% to 20% of patients with implantable cardioverter-defibrillators. This frightening clinical emergency also predicts an increased risk of subsequent cardiac death among survivors. This case series assesses the role of catheter ablation in controlling ES and the subsequent long-term incidence of recurrent ventricular tachycardia and cardiac mortality. Ninety-five patients with structural heart disease undergoing catheter ablation for drug-refractory ES were prospectively evaluated. Advanced strategies of mapping and ablation were used in most patients. After 1 to 3 procedures, ES was suppressed in all patients. Programmed electrical stimulation showed that all inducible clinical ventricular tachycardias were abolished in 89% of patients. At a median follow-up of 22 months, 92% of patients were free of ES; 8 patients had recurrent ES, 4 of whom died despite implantable cardioverter-defibrillator intervention. The total cardiac mortality rate was 12%, which compares favorably with the reported late mortality rates for patients who suffer ES. Acute results of catheter ablation predicted the absence of ES recurrence and correlated with reduced cardiac mortality. These observations support the early use of catheter ablation as adjunctive therapy for the treatment of ES. This experience lays the foundation for further studies to determine whether controlling ES with catheter ablation improves long-term survival. See p 462.

	Pulmonary Vein Region Ablation in Experimental Vagal Atrial Fibrillation: Role of Pulmonary Veins Versus Autonomic Ganglia

 
Ablation procedures directed at the pulmonary vein (PV) region have had a very important impact on the management of atrial fibrillation (AF). PV-directed procedures initially targeted highly localized arrhythmogenic . . . [Full Text of this Article]

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