Arrhythmias & electrophysiologyMeta-analysis
Catheter ablation vs. anti-arrhythmic drug therapy for ventricular tachycardia in ischaemic heart disease: a meta-analysis of randomized controlled trials
- Systematic review and meta-analysis of randomised trials
Authors' conclusion
In ischaemic heart disease and VT, CA compared with anti-arrhythmic drugs is associated with a reduction of appropriate ICD therapy, cardiovascular re-hospitalization, and adverse events with benefits most evident versus sotalol.
Study context
- Population
- Patients with ischaemic heart disease, ventricular tachycardia (VT) and ICD
- Participants
- 947 patients · 4 randomized controlled trials (RCTs)
- Comparison
- Catheter ablation vs anti-arrhythmic drugs
- Catheter ablation (CA)n = 470
- Anti-arrhythmic drugs (AADs)n = 477reference
- Outcome
- Appropriate ICD therapy
Pooled result
As reported in the abstract
Relative risk
0.81
95% CI 0.67–0.97
P = 0.02
Events by group
CA vs AADs
RR 0.81 (95% CI 0.67–0.97); P = 0.02
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| CV re-hospitalization | 0.84 (0.72–0.99) | P = 0.04 | |
| Composite of ICD shock, VT storm and all-cause death, vs sotalol (subgroup) · exploratory | 0.82 (0.69–0.98) | P = 0.03 | |
| Composite of ICD shock, VT storm and all-cause death, vs amiodarone (subgroup) · exploratory | 0.92 (0.78–1.09) | P = 0.32 | |
| 0.512Relative risk (log scale) |
All-cause/cardiovascular (CV) mortality and inappropriate ICD therapy
- No differences observed
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Adverse events | 0.42 (0.28–0.62) | P < 0.01 | |
| 0.20.5125Relative risk (log scale) |
Original publication
Catheter ablation vs. anti-arrhythmic drug therapy for ventricular tachycardia in ischaemic heart disease: a meta-analysis of randomized controlled trials. Europace. Published 29 November 2025. doi:10.1093/europace/euaf302
Summarised from the published abstract; every number is checked against it