Arrhythmias & electrophysiologyRandomised controlled trial
Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia
- Randomised controlled trial
- international
Authors' conclusion
Among patients with ischemic cardiomyopathy and ventricular tachycardia, an initial strategy of catheter ablation led to a lower risk of a composite primary end-point event than antiarrhythmic drug therapy.
Study context
- Population
- Patients with previous MI and clinically significant VT (VT storm, appropriate ICD shock or antitachycardia pacing, or sustained VT terminated by emergency treatment), all with an ICD
- Participants
- 416 patients
- Comparison
- Catheter ablation vs Drug therapy
- Catheter ablationn = 203
- Drug therapyn = 213reference
- Primary endpoint
- Composite of:
- All-cause death during follow-up or
- >14 days after randomization
- VT storm
- Appropriate ICD shock
- Sustained VT treated by medical intervention
- Follow-up
- Median 4.3 years
Primary result
As reported in the abstract
Hazard ratio
0.75
95% CI 0.58–0.97
P = 0.03
Events by treatment group
Catheter ablation vs Drug therapy
HR 0.75 (95% CI 0.58–0.97); P = 0.03
Safety
| Outcome | Catheter ablation | Drug therapy |
|---|---|---|
| Procedure-related adverse events within 30 days (ablation) | ||
| Death | 2 (1.0%) | Not reported in the abstract |
| Nonfatal adverse events | 23 (11.3%) | Not reported in the abstract |
| Adverse events attributed to antiarrhythmic drug treatment | ||
| Death from pulmonary toxic effects | Not reported in the abstract | 1 (0.5%) |
| Nonfatal adverse events | Not reported in the abstract | 46 (21.6%) |
Original publication
Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia. N Engl J Med. Published 16 November 2024. doi:10.1056/nejmoa2409501
Summarised from the published abstract; every number is checked against it