Arrhythmias & electrophysiologyRandomised controlled trial
Can ICD Electrograms Help Ventricular Tachycardia Ablation?
- Randomised controlled trial
- multicentre
- 1:1 randomisation
Authors' conclusion
In patients with structural heart disease and ICD-documented SMVT, using ICD-EG information during the ablation procedure to focalize ablation toward the clinical ventricular tachycardia is associated with a nonsignificant decrease in SMVT recurrence rate, a significant reduction in the number of ventricular tachycardia episodes, and a lower rate of arrhythmic storm.
Study context
- Population
- Patients with structural heart disease and sustained monomorphic ventricular tachycardia (SMVT) documented by an ICD-EG, undergoing ablation
- Participants
- 260 patients · 15 centres
- Comparison
- Ablation guided by ICD electrogram data vs conventional ablation
- Primary endpoint
- SMVT recurrence
- Follow-up
- Within 6 months postablation
Primary result
As reported in the abstract
6 months postablation
Hazard ratio
0.73
95% CI 0.49–1.07
P = 0.11
Events by treatment group
Intervention vs Conventional
HR 0.73 (95% CI 0.49–1.07); P = 0.11
Further findings
| Outcome | Intervention | Conventional | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Number of SMVT episodes · significantly lower in intervention | 0.45 (0.24–0.84) | P = 0.013 | |||
| Electrical storm | 23% | 41% | 0.54 (0.34–0.85) | P = 0.007 | |
| 0.20.5125Hazard ratio (log scale) |
SMVT recurrence, per-protocol analysis · 6 months postablation
- Per-protocol SMVT recurrence reached statistical significance: HR
- 0.66 (95% CI 0.44-0.99)
- P
- P = 0.045
SMVT recurrence, entire follow-up (44 ± 29 months)
- SMVT recurrence, intervention vs conventional (as printed in order)
- 67% and 76%
- HR (95% CI 0.60-1.08), P = 0.14
- 0.80
ICD shocks
- No differences in ICD shocks
Acute efficacy
- No differences in acute efficacy
Original publication
Can ICD Electrograms Help Ventricular Tachycardia Ablation? J Am Coll Cardiol. Published 8 January 2025. doi:10.1016/j.jacc.2024.10.104
Summarised from the published abstract; every number is checked against it