When to Ablate Ventricular Tachycardia in Patients with an ICD

VT ablation after the first appropriate ICD shock, and before use of amiodarone, was associated with lower mortality.

Ablation of ventricular tachycardia (VT) is viewed as an adjunctive treatment in patients with nonischemic or ischemic cardiomyopathy who qualify for an implantable cardioverter–defibrillator (ICD). Evidence on whether to ablate VT at the time of ICD implantation is mixed, and many clinicians prefer to have one or more clinical recurrences of VT prompt the decision to pursue ablation. Researchers now explore this dilemma in a two-phase study (NCT01547208) funded by an ICD maker.

In the first phase, 517 patients with ischemic or nonischemic cardiomyopathy (21% with secondary-prevention indications for an ICD) were followed prospectively. Of 154 patients who had sustained VT episodes, 56 received a first appropriate shock for VT, leaving 98 wh…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

When to Ablate Ventricular Tachycardia in Patients with an ICD

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Reviewing Author