Why the study?
AF can trigger episodes of VT or VF in patients with an ICD, but left ventricular thrombus is an important contraindication to endocardial VT ablation.
Catheter ablation of atrial arrhythmias may serve as an alternative strategy to prevent ventricular tachycardia in patients where endocardial VT ablation is contraindicated due to left ventricular thrombus.
May support ablation in select ICD patients with LV thrombus; hypothesis-generating and requires prospective confirmation.
Atrial fibrillation (AF) is a leading cause of inappropriate shocks in patients with an implantable cardioverter-defibrillator (ICD), but can also trigger episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF), leading to appropriate ICD therapies.1 Although many antiarrhythmic drugs have effects on both atrial and ventricular arrhythmias, catheter ablation is an effective therapy for both AF and VT, especially when refractory to antiarrhythmics. Left ventricular (LV) thrombus is an important contraindication to endocardial VT ablation.
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Patel et al. (2021) studied this question.
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