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0230 : Effectiveness of extracorporeal life support for patients with cardiogenic shock due to intractable arrhythmic storm
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Edité par CCSD -
International audience. Background Extracorporeal life support (ECLS) provides mechanical cardiopulmonary support and has been used for intractable heart failure as a bridge to heart transplantation or to recovery. Intractable arrhythmic storm is associated with high mortality. Little is known about the effectiveness of ECLS to treat refractory ventricular arrhythmias responsible for cardiogenic shock in patients non eligible for an urgent ablation. Methods Patients with intractable refractory ventricular arrhythmias and cardiogenic shock despite optimal medical therapy, and treated by ECLS implantation were retrospectively included. Patients’ characteristics and outcome were analyzed. Results 20 patients (53±10 yo) were included. The underlying etiology to the refractory ventricular storm was ischemic cardiomyopathy (75%), short coupled Torsades de Pointes (10%), dilated cardiomyopathy (5%), myocarditis (5%) or unknown (5%). Mean LVEF was 33±17%. An average of 2.3±1.2 anti-arrhythmic drugs was tried before implantation. Arrhythmic storm stopped after a median time of 15min after ECLS implantation. 8 patients (40%) eventually died, none of them because of a complication of ECLS implantation. The remaining 12 patients (60%) had ECLS withdrawn after a median time of 5.3 days, and were discharged after a median time of 29 days after admission (survival curve in the figure). Conclusion This is the largest database of patients temporary implanted with ECLS for refractory ventricular arrhythmia responsible for cardiogenic shock and non eligible for ablation. It provides efficient hemodynamic support to these critically ill patients, and survival rate after the implantation is 60%. Figure: Survival curve
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