Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): an on-treatment analysis
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Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): an on-treatment analysis. / Delacrétaz, Etienne; Brenner, Roman; Schaumann, Anselm; Eckardt, Lars; Willems, Stephan; Pitschner, Heinz-Friedrich; Kautzner, Josef; Schumacher, Burghard; Hansen, Peter S; Kuck, Karl-Heinz; VTACH Study Group.
In: J CARDIOVASC ELECTR, Vol. 24, No. 5, 05.2013, p. 525-529.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): an on-treatment analysis
AU - Delacrétaz, Etienne
AU - Brenner, Roman
AU - Schaumann, Anselm
AU - Eckardt, Lars
AU - Willems, Stephan
AU - Pitschner, Heinz-Friedrich
AU - Kautzner, Josef
AU - Schumacher, Burghard
AU - Hansen, Peter S
AU - Kuck, Karl-Heinz
AU - VTACH Study Group
N1 - © 2012 Wiley Periodicals, Inc.
PY - 2013/5
Y1 - 2013/5
N2 - BACKGROUND: In the Ventricular Tachycardia Ablation in Coronary Heart Disease (VTACH) study, an intention-to-treat approach was used and may have diminished the observed degree of treatment effect. We present a subanalysis of the VTACH study by treatment actually received.METHODS AND RESULTS: The VTACH study was a prospective, open, randomized controlled trial, undertaken in 16 European centers, comparing defibrillator implantation with and without ventricular tachycardia (VT) ablation in patients with stable VT, previous myocardial infarction, and reduced left-ventricular ejection fraction. Of the 52 patients in the ablation group, 7 (13%) did not receive VT ablation and 19% of patients assigned to implantable cardioverter defibrillator (ICD) only treatment group crossed over and had an ablation. The primary endpoint (first recurrence of any documented VT or ventricular fibrillation [VF]) was reached after a median of 19.5 months in the ablation group and 5.9 months in the ICD only group (P = 0.01). Overall, 685 VT/VF events occurred per year of follow-up in 22 patients of the ablation group and 4,986 events in 43 patients of the control group (P = 0.024). In the ICD only group, median numbers of VT/VF episodes were 25 (IQR 5.8-45.3) and 1.5 (IQR 0-24.8) per patient and year before and after crossover (n = 12), respectively.CONCLUSION: On-treatment analysis of the VTACH study emphasizes the effectiveness of VT ablation in patients receiving ICD treatment because of monomorphic VT post myocardial infarction. VT ablation clearly prolonged time to recurrence of VT/VF episodes and markedly decreased VT/VF burden.
AB - BACKGROUND: In the Ventricular Tachycardia Ablation in Coronary Heart Disease (VTACH) study, an intention-to-treat approach was used and may have diminished the observed degree of treatment effect. We present a subanalysis of the VTACH study by treatment actually received.METHODS AND RESULTS: The VTACH study was a prospective, open, randomized controlled trial, undertaken in 16 European centers, comparing defibrillator implantation with and without ventricular tachycardia (VT) ablation in patients with stable VT, previous myocardial infarction, and reduced left-ventricular ejection fraction. Of the 52 patients in the ablation group, 7 (13%) did not receive VT ablation and 19% of patients assigned to implantable cardioverter defibrillator (ICD) only treatment group crossed over and had an ablation. The primary endpoint (first recurrence of any documented VT or ventricular fibrillation [VF]) was reached after a median of 19.5 months in the ablation group and 5.9 months in the ICD only group (P = 0.01). Overall, 685 VT/VF events occurred per year of follow-up in 22 patients of the ablation group and 4,986 events in 43 patients of the control group (P = 0.024). In the ICD only group, median numbers of VT/VF episodes were 25 (IQR 5.8-45.3) and 1.5 (IQR 0-24.8) per patient and year before and after crossover (n = 12), respectively.CONCLUSION: On-treatment analysis of the VTACH study emphasizes the effectiveness of VT ablation in patients receiving ICD treatment because of monomorphic VT post myocardial infarction. VT ablation clearly prolonged time to recurrence of VT/VF episodes and markedly decreased VT/VF burden.
KW - Aged
KW - Catheter Ablation
KW - Defibrillators, Implantable
KW - Female
KW - Humans
KW - Intention to Treat Analysis
KW - Male
KW - Myocardial Infarction/complications
KW - Prospective Studies
KW - Prosthesis Implantation
KW - Stroke Volume
KW - Tachycardia, Ventricular/surgery
KW - Ventricular Fibrillation
U2 - 10.1111/jce.12073
DO - 10.1111/jce.12073
M3 - SCORING: Journal article
C2 - 23350967
VL - 24
SP - 525
EP - 529
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 5
ER -