This survey highlights current European clinical practice for managing sustained VT, showing high adherence to ICD guidelines but low utilization of early radiofrequency ablation for secondary prevention.
Highlights gap between ICD guideline adherence and early ablation use; leaves open optimal integration of ablation in secondary prevention.
The purpose of the EP wire is to examine the clinical practice in the management of sustained ventricular tachycardia (VT), with special focus on diagnostic and therapeutic strategies. Forty-five European centres, all members of the EHRA-EP Research network completed the questions of the survey. There was an equal distribution of centres with high, medium, and low volume of activity. The most common aetiologies were: post-myocardial infarction ischaemic heart disease (55%), followed by idiopathic dilated cardiomyopathy (18%), and idiopathic VT (11%) and others (12%). Cardiac magnetic resonance imaging was performed in more than 50% of patients in 24 centres (62.2%). Invasive electrophysiological study was performed in more than 70% of patients in 16 centres (35.6%), between 51 and 70% in 9 (20%), below 50% in 20 (44.5%). In 39 centres (86.7%), implantable cardioverter defibrillator implantation was considered in all patients with structural heart disease and left ventricular ejection fraction <35%. In the setting of secondary prevention, early radiofrequency ablation of the VT was performed in more than 50% of the patients in only five centres (11.4%). Sequential endo-epicardial approach was reported in 52.2% of centres.
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Proclemer et al. (2013) studied this question.
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