Noninducibility of VT after VT ablation is associated with improved arrhythmia-free survival and all-cause mortality
BACKGROUND Although ventricular tachycardia ( VT ) ablation is a widely used therapy for patients with VT , the ideal end points for this procedure are not well defined .
We performed a meta- analysis of the published literature to assess the predictive value of noninducibility of postinfa rct ion VT for long-term outcomes after VT ablation .
Prophylactic catheter ablation for the prevention of defibrillator therapy.
BACKGROUND For patients who have a ventricular tachyarrhythmic event , implantable cardioverter-defibrillators ( ICDs ) are a mainstay of therapy to prevent sudden death . However , ICD shocks are painful , can result in clinical depression , and do not offer complete protection against death from arrhythmia . We design ed this r and omized trial to examine whether prophylactic radiofrequency catheter ablation of arrhythmogenic ventricular tissue would reduce the incidence of ICD therapy . METHODS Eligible patients with a history of a myocardial infa rct ion underwent defibrillator implantation for spontaneous ventricular tachycardia or fibrillation . The patients did not receive  antiarrhythmic drugs .  Patients were r and omly assigned to  defibrillator implantation alone or defibrillator implantation with adjunctive catheter ablation  ( 64 patients in each group ) . Ablation was performed with the use of a substrate-based approach in which the myocardial scar is mapped and ablated while the heart remains predominantly in sinus rhythm . The primary end point was survival free from any appropriate ICD therapy . RESULTS The mortality rate 30 days after ablation was zero , and there were no significant changes in ventricular function or functional class during the mean ( + /-SD ) follow-up period of 22.5+/-5.5 months . Twenty-one patients assigned to defibrillator implantation alone ( 33 % ) and eight patients assigned to defibrillator implantation plus ablation ( 12 % ) received appropriate ICD therapy ( antitachycardia pacing or shocks ) ( hazard ratio in the ablation group , 0.35 ; 95 % confidence interval , 0.15 to 0.78 , P=0.007 ) . Among these patients , 20 in the control group ( 31 % ) and 6 in the ablation group ( 9 % ) received shocks ( P=0.003 ) . Mortality was not increased in the group assigned to ablation as compared with the control group ( 9 % vs. 17 % , P=0.29 ) . CONCLUSIONS In this r and omized trial , prophylactic substrate-based catheter ablation reduced the incidence of ICD therapy in patients with a history of myocardial infa rct ion who received ICDs for the secondary prevention of sudden death . ( Current Controlled Trials number , IS RCT N62488166 [ controlled-trials.com ] . )
Noninducibility of VT after VT ablation is associated with improved arrhythmia-free survival and all-cause mortality
BACKGROUND Although ventricular tachycardia ( VT ) ablation is a widely used therapy for patients with VT , the ideal end points for this procedure are not well defined .
We performed a meta- analysis of the published literature to assess the predictive value of noninducibility of postinfa rct ion VT for long-term outcomes after VT ablation .