Arrhythmias & electrophysiologyRandomised controlled trial
Impact of preventive substrate catheter ablation on implantable cardioverter-defibrillator interventions in patients with ischaemic cardiomyopathy and infarct-related coronary chronic total occlusion
- Randomised controlled trial
- prospective
- multicentre
Authors' conclusion
Preventive ablation of the coronary CTO-related substrate in patients undergoing primary ICD implantation is associated with the reduced risk of appropriate ICD therapy or unplanned hospitalization due to VAs.
Study context
- Population
- Ischaemic patients with EF ≤40%, no documented ventricular arrhythmias and scar related to an infarct-related coronary CTO, undergoing primary prevention implantable cardioverter-defibrillator (ICD) implantation
- Participants
- 60 patients
- Comparison
- Preventive ablation vs ICD only
- Primary endpoint
- Composite of:
- Appropriate ICD therapy
- Unplanned hospitalization for ventricular arrhythmias
- Follow-up
- Mean 44.7 ± 20.7 months
Primary result
As reported in the abstract
Hazard ratio
0.33
95% CI 0.12–0.94
P = 0.037
Events by treatment group
Preventive ablation vs ICD only
HR 0.33 (95% CI 0.12–0.94); P = 0.037
Secondary outcomes
Appropriate ICD therapies
- Fewer appropriate ICD therapies with preventive ablation
- P = 0.039
Electrical storm
- Fewer electrical storms with preventive ablation
- Log-rank: P = 0.01
Cardiac hospitalization
- Reduced with preventive ablation
- P = 0.006
Cardiovascular (CV) mortality
- No significant impact of preventive ablation
- P = 0.151
Original publication
Impact of preventive substrate catheter ablation on implantable cardioverter-defibrillator interventions in patients with ischaemic cardiomyopathy and infarct-related coronary chronic total occlusion. Europace. Published 24 April 2024. doi:10.1093/europace/euae109
Summarised from the published abstract; every number is checked against it