Catheter ablation alone without ICD implantation in patients with structural heart disease, well-tolerated sustained VT, and preserved LVEF does not appear to carry a significant risk of sudden death.
Does catheter ablation alone prevent sudden death as effectively as ICD implantation in patients with structural heart disease, preserved LVEF, and well-tolerated sustained ventricular tachycardia?
Catheter ablation alone may be a safe alternative to ICD implantation in selected patients with structural heart disease, preserved LVEF, and well-tolerated VT, though randomized trials are urgently needed.
INTRODUCTION: The occurrence of a sustained monomorphic ventricular tachycardia in patients with structural heart disease is a class 1 indication for ICD because of the expected relevant risk of sudden death. However, if this concerns selected patients with preserved left ventricular function and well-tolerated arrhythmias is still poorly known. AREAS COVERED: In this article, we review the available data about the natural history of nonimplanted patients with structural heart disease and sustained ventricular tachycardia and the possible role of catheter ablation alone in this population. EXPERT OPINION: In structural heart disease patients with well-tolerated sustained ventricular tachycardia and preserved LVEF, catheter ablation alone, without ICD implantation, does not seem to carry an important risk of sudden death and the prognosis of these patients is mainly nonarrhythmic. Randomized prospective trials are urgently needed for evaluating the place of first choice ablation without ICD implantation in these populations.
Maury et al. (Wed,) conducted a review in Structural heart disease with sustained ventricular tachycardia and preserved LVEF. Catheter ablation alone vs. Implantable cardioverter-defibrillators (ICD) was evaluated on Sudden death. Catheter ablation alone without ICD implantation in patients with structural heart disease, well-tolerated sustained VT, and preserved LVEF does not appear to carry a significant risk of sudden death.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: