Title |
Prophylactic catheter ablation of ventricular tachycardia in ischemic cardiomyopathy: a systematic review and meta-analysis of randomized controlled trials
|
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Published in |
Journal of Interventional Cardiac Electrophysiology, April 2018
|
DOI | 10.1007/s10840-018-0376-5 |
Pubmed ID | |
Authors |
Varunsiri Atti, Venkat Vuddanda, Mohit K. Turagam, Praveen Vemula, Zubair Shah, Himakar Nagam, Srikanth Yandrapalli, Mohammad-Ali Jazayeri, Scott Koerber, Juan Viles Gonzalez, Andrea Natale, Luigi Di Biase, Dhanunjaya R. Lakkireddy |
Abstract |
Catheter ablation is proven to be an effective strategy for drug refractory ventricular tachycardia (VT) in ischemic cardiomyopathy. However, the appropriate timing of VT ablation and identifying the group of patients that may receive the greatest benefit remains uncertain. There is limited data on the effect on prophylactic catheter ablation (PCA) in the prevention of implantable cardioverter defibrillator (ICD) therapy, electrical storm, and mortality. We performed a comprehensive literature search through November 1, 2017, for all eligible studies comparing PCA + ICD versus ICD only in eligible patients with ischemic cardiomyopathy. Clinical outcomes included all ICD therapies including ICD shocks and electrical storm. Additional outcomes included all-cause mortality, cardiovascular mortality, and complications. Three randomized controlled trials (RCTs) (N = 346) met inclusion criteria. PCA was associated with a significantly lower ICD therapies (OR 0.49; CI 0.28 to 0.87; p = 0.01) including ICD shocks [OR 0.38; CI 0.22 to 0.64; p = 0.0003) and electrical storm (OR 0.55; CI 0.30 to 1.01; p = 0.05) when compared with ICD only. There was no significant difference in all-cause mortality (OR 0.77; CI 0.41 to 1.46; p = 0.42), cardiovascular mortality (OR 0.49; CI 0.16 to 1.50; p = 0.21), and major adverse events (OR 1.45; CI 0.52 to 4.01; p = 0.47) between two groups. These results suggest prophylactic catheter ablation decreases ICD therapies, including shocks and electrical storm with no improvement in overall mortality. There is a need for future carefully designed randomized clinical trials. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 2 | 67% |
United Kingdom | 1 | 33% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 67% |
Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 43 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Other | 4 | 9% |
Researcher | 4 | 9% |
Professor > Associate Professor | 3 | 7% |
Professor | 3 | 7% |
Student > Bachelor | 3 | 7% |
Other | 11 | 26% |
Unknown | 15 | 35% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 17 | 40% |
Nursing and Health Professions | 2 | 5% |
Agricultural and Biological Sciences | 1 | 2% |
Economics, Econometrics and Finance | 1 | 2% |
Social Sciences | 1 | 2% |
Other | 3 | 7% |
Unknown | 18 | 42% |