Ventricular Tachycardia Ablation to Reduce Implantable Cardioverter-Defibrillator Interventions

Implantable cardioverter-defibrillators can be lifesaving in patients with cardiomyopathy. However, ICD therapy is painful, may actually lead to clinical deterioration, and does not always prevent sudden cardiac death. Catheter ablation for ventricular tachycardia (VT) is effective in reducing the number of ICD interventions, but we do not know which patients will benefit the most from ablation and what its optimal timing is relative to ICD implantation. In a multicenter European study sponsored by an ICD manufacturer, 107 adults with ischemic cardiomyopathy and clinically stable VT (without fibrillation) were randomized to ICD implantation with or without prophylactic ablation.

Forty-five patients underwent ablation (8 patients randomized t…