Ventricular arrhythmia ablation timing and outcomes in electrical STORM requiring V-A ECMO support: the STORM-ECMO study
Main findingResult — go to the resultCause-specific hazard ratio 1.72 95% CI 1.08–2.73Authors' conclusion
In patients with ES-related refractory cardiogenic shock supported by V-A ECMO, VA ablation was associated with a higher probability of successful ECMO weaning, particularly when performed within the early days after cannulation.
Study context
- Population
- Patients requiring V-A ECMO for electrical storm-related refractory cardiogenic shock, 9 French tertiary centres, 2015–2023
- Participants
- 218 patients · 9 centres
- Exposure
- Ventricular arrhythmia (VA) ablation vs no ablation during V-A ECMO
- VA ablationn = 115
- No ablationn = 103reference
- Outcome
- Successful ECMO weaning (liberation from ECMO alive without transition to durable mechanical circulatory support or heart transplantation)
- Follow-up
- 28 days after ECMO liberation
Methodological detailsmulticentre, propensity-score matching, time-dependent Cox models, landmark Fine & Gray competing-risk analyses
- Multicentre
- Propensity-score matching
- Time-dependent Cox models
- Landmark Fine & Gray competing-risk analyses
Main finding
As reported in the abstract
Cause-specific hazard ratio
1.72
95% CI 1.08–2.73
P = 0.022
VA ablation vs No ablation
cs-HR 1.72 (95% CI 1.08–2.73); P = 0.022
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| ECMO weaning success, early (≤ Day 4) vs later ablation, among ablated patients | HR 2.10 (95% CI 1.14–3.87) | P = 0.01 | |
| Cumulative incidence of successful weaning, early ablation vs late or no ablation (landmark Fine & Gray model) | sHR 2.23 (95% CI 1.26–3.87) | P = 0.0045 | |
| 0.20.5125Ratio (log scale) |
ECMO weaning success by timing of ablation (spline-based Cox analysis)
- Benefit greatest when ablation performed within the first days of support, progressively attenuating thereafter
Original publication
Ventricular arrhythmia ablation timing and outcomes in electrical STORM requiring V-A ECMO support: the STORM-ECMO study. Crit Care. Published 24 March 2026. doi:10.
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