Arrhythmias & electrophysiology
Bayesian analysis of the Substrate Ablation vs. Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia trial
Authors' conclusion
In patients with ischaemic cardiomyopathy and VT, catheter ablation as a first-line therapy resulted in a high probability of reducing several clinical outcomes compared to AAD.
Study context
- Population
- Patients with ischaemic cardiomyopathy and monomorphic ventricular tachycardia (VT)randomised
- Participants
- 144 patients
- Comparison
- Catheter ablation vs AAD as first-line strategy
- Catheter ablationn = 71
- AADn = 73reference
- Primary endpoint
- Composite of:
- CV death
- Appropriate ICD shocks
- Unplanned HF hospitalisations
- Severe treatment-related complications
Methodological detailsBayesian survival models, informative, skeptical and non-informative priors
- Bayesian survival models
- Informative, skeptical and non-informative priors
Primary result
As reported in the abstract
Primary composite outcome
Probability catheter ablation reduces primary outcome (HR < 1), regardless of prior
>98%
Probability of reduction >10% (HR < 0.9), regardless of prior
>96%
Further findings
Incessant/slow undetected VT/electric storm, unplanned hospitalisations for ventricular arrhythmias, overall CV admissions
- Probability catheter ablation reduces each outcome > 25%
- >93%
- Absolute difference, incessant/slow undetected VT/electric storm
- 15.2%
- Absolute difference, unplanned hospitalisations for ventricular arrhythmias
- 21.2%
- Absolute difference, overall CV admissions
- 20.2%
Safety
Treatment-related complications
- Probability of a >25% reduction (HR < 0.75) with catheter ablation
- >90%
Original publication
Bayesian analysis of the Substrate Ablation vs. Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia trial. Europace. Published 27 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it