Ablation of Stable VTs Versus Substrate Ablation in Ischemic Cardiomyopathy
Why the study?
Catheter ablation reduces VT recurrence and ICD shocks in ischemic cardiomyopathy, but the most effective catheter ablation technique is unknown.
Does substrate-based ablation reduce VT recurrence compared to clinical VT ablation in patients with ischemic cardiomyopathy and hemodynamically tolerated VT?
Comparison
Clinical ablation vs substrate-based ablation
Design
Randomized multicenter trial
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Substrate ablation in ischemic VT was associated with fewer recurrences; leaves open optimal strategy pending randomized confirmation.
Structured PICO
Does substrate-based ablation reduce VT recurrence compared to clinical VT ablation in patients with ischemic cardiomyopathy and hemodynamically tolerated VT?
P
Population
118 subjects with ischemic cardiomyopathy and hemodynamically tolerated VT
I
Intervention
Substrate-based ablation targeting all 'abnormal' electrograms in the scar
C
Comparator
Clinical ablation limited to clinical VT along with mappable VTs
O
Outcome
Recurrence of VT at 12-month follow-up
In patients with ischemic cardiomyopathy and tolerated VT, an extensive substrate-based ablation approach significantly reduces VT recurrence compared to ablation targeting only clinical and stable VTs.
Cite This Study
Biase et al. (2015) studied this question.