Objectives: The study evaluates the prognostic impact of age and gender in patients with an electrical storm (ES). 

Background: ES represents a severe and life-threatening heart rhythm disorder. Age and male gender have been identified as independent risk factors for cardiovascular diseases. However, data regarding the prognostic impact of age and gender in ES patients is limited.  

Methods: The present longitudinal observational registry-based monocentric cohort study included retrospectively all consecutive patients presenting with ventricular tachyarrhythmias from 2002 to 2016. Patients ≥ 68 years were compared to patients < 68 years, and males were compared to females. The primary endpoint was all-cause mortality at three years. At three years, secondary endpoints were in-hospital mortality, rehospitalization rates, electrical storm (ES-R) recurrences, and major adverse cardiac events (MACE). 
 

Results: A total of 87 ES-patients with ICD were included. Age ≥ 68 years was associated with increased all-cause mortality at three years (48% vs. 20%, HR=3.046; 95% CI 1.316-7.051; p=0.008; log-rank p=0.009) and with MACE (50% vs. 26%, HR=2.397; 95% CI 0.598-5.121; p=0.023; log-rank p=0.020). In-hospital mortality, rehospitalization rates, and ES-R were not affected by age. Even after multivariable adjustment, age ≥ 68 years was associated with increased long-term mortality at three years (HR=3.247, 95% CI 1.121-9.408, p=0.030), besides LVEF < 35% (HR=11.170, 95% CI 2.231-55.92, p=0.003), whereas age ≥ 68 years was not associated with MACE after multivariable adjustment. In contrast, gender was not associated with the primary and secondary endpoints.

Conclusion: Patients ≥ 68 years are associated with poor long-term prognosis at three years and MACE when presenting with an electrical storm. Increased long-term mortality was still evident after multivariable adjustment, besides LVEF < 35%. In contrast, gender was not associated with the primary and secondary endpoints.