Prophylactic catheter ablation for induced monomorphic VT significantly reduced the incidence of appropriate ICD therapy compared to no ablation (5% vs 65%; P=0.003) in primary prevention patients.
Cohort (n=38)
Does prophylactic catheter ablation reduce the incidence of appropriate ICD therapy in patients with structural heart disease and inducible monomorphic VT receiving a primary prevention ICD?
Prophylactic catheter ablation for induced monomorphic VT significantly reduces the incidence of appropriate ICD therapy, including shocks, in patients with structural heart disease receiving an ICD for primary prevention.
Absolute Event Rate: 5% vs 65%
p-value: p=0.003
AIMS: Prophylactic catheter ablation (CA) has been established to reduce the incidence of appropriate implantable cardioverter-defibrillator (ICD) therapy (anti-tachycardia pacing or shock) in secondary prevention patients. The aim of this study was to determine whether prophylactic CA for induced ventricular tachycardia (VT) reduces the incidence of appropriate ICD therapy in primary prevention patients. METHODS AND RESULTS: We retrospectively investigated 66 consecutive patients with structural heart disease who had undergone ICD implantation as primary prevention and electrophysiological study. Patients with hypertrophic cardiomyopathy or no inducible monomorphic VT had been excluded, and the remaining 38 patients were divided into two groups; those who had undergone prophylactic CA for induced monomorphic VT (the CA group, n = 18), and those who had not undergone CA (the non-CA group, n = 20). During a mean follow-up of 50 ± 38 months, 1 patient (5%) received appropriate ICD therapy in the CA group and 13 (65%) in the non-CA group. Kaplan-Meier survival analysis revealed a significantly higher event-free survival rates for appropriate ICD therapy in the CA group compared with the non-CA group (P = 0.003). Among the patients, one patient (5%) in the CA group and nine patients (45%) in the non-CA group suffered appropriate shock (P = 0.018). CONCLUSIONS: Prophylactic CA for induced monomorphic VT reduces the incidence of appropriate ICD therapy including shock in primary prevention patients. These results indicate that prophylactic CA may be considered for structural heart disease patients who are candidates for ICD implantation as primary prevention.
Hayashi et al. (Fri,) conducted a cohort in Structural heart disease with ICD for primary prevention and induced monomorphic VT (n=38). Prophylactic catheter ablation vs. No prophylactic catheter ablation was evaluated on Appropriate ICD therapy (anti-tachycardia pacing or shock) (p=0.003). Prophylactic catheter ablation for induced monomorphic VT significantly reduced the incidence of appropriate ICD therapy compared to no ablation (5% vs 65%; P=0.003) in primary prevention patients.