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Catheter Ablation for Electrical Storm Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Session:
Sessão de Comunicações Orais 15 – Instabilidade eléctrica e terapêuticas do sistema de condução: do pacing à tempestade arrítmica
Speaker:
Mafalda de Oliveira Griné
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Mafalda Oliveira Grine; Gonçalo Terleira Batista; Gonçalo Ferraz-Costa; Carolina Saleiro; Patrícia Alves; João Ferreira; Natália António; Pedro A. Sousa; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background</strong>: Electrical storm (ES) is a life-threatening clinical condition. Catheter ablation (CA) has emerged as a potential strategy for reducing arrhythmic burden and preventing ES.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Objective</strong>: To assess the efficacy of CA in preventing ES in patients with structural heart disease and documented ventricular arrhythmias.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) assessing CA versus conventional management in adult patients with structural heart disease and documented ventricular arrythmias. The primary outcome was ES occurrence. Secondary outcomes included all-cause mortality, cardiovascular mortality, cardiovascular hospitalization, and appropriate implantable cardioverter-defibrillator (ICD) shocks. Studies with insufficient event reporting were excluded. Odds ratios (ORs) were pooled using a random-effects model with Wald-type confidence intervals.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: Eight eligible RCTs comprising 1283 patients were included in the primary outcome analysis. ES occurred in 111/627 CA patients and in 149/643 Control patients. CA significantly reduced the odds of ES: OR = 0.70 (95% CI 0.53–0.93; p = 0.01); I² = 0%. CA was also associated with less cardiovascular hospitalizations [OR = 0.73 (95% CI 0.55-0.95); p = 0.02; I² = 13%], and less appropriate ICD shocks [OR = 0.53 (95% CI 0.35-0.79; p = 0.002; I² = 55%]. No significant differences were observed in all-cause or cardiovascular mortality. When restricting the analysis to trials enrolling only patients with ischemic cardiomyopathy, the effect size remained essentially unchanged [ES: OR = 0.71 (95% CI 0.53-0.94); p = 0.02; I² = 0%].</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong>: This meta-analysis suggests that CA significantly reduces the risk of electrical storm, appropriate ICD shocks and cardiovascular hospitalization compared with standard therapy.</span></span></span></p>
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