SMASHing Ventricular Tachyarrhythmias: Can Ablation Prevent Implantable Cardioverter-Defibrillator Events?

Implantable cardioverter-defibrillator (ICD) therapy reduces mortality in patients with decreased LV function, coronary artery disease, and ventricular arrhythmias (Journal Watch Cardiology Dec 31 1998) by terminating spontaneous ventricular arrhythmias, not by preventing them. However, ICD shocks may cause considerable psychological and other morbidity, and arrhythmias may cause syncope. Limited trial data suggest that antiarrhythmic agents reduce recurrence of ventricular arrhythmias; however, the potential toxicity of these agents has limited their use to treatment of individuals who experience frequent ICD shocks, rather than prophylaxis of arrhythmias.

In the Substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular Tachycardia…