ESC Congress FA eBook 2016 - 24

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Figure 2. Effect of Prophylactic VT Ablation on Survival in VT
Patients With MI
Ablation group
Control group

100
Survival Free From VT or VF, %

90
80
70
60
50
40
30
20
10
0

P = .045
0

No. at risk
Ablation group 52
Control group 55

24
Time, m

34
26

28
21

21
12

9
8

3
4

0
0

MI, myocardial infarction; VF, ventricular fibrillation; VT, ventricular tachycardia.
Reprinted from Kuck KH et al. Catheter ablation of stable ventricular tachycardia before
defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre
randomised controlled trial. Lancet. 2010;375(9708):31-40. By permission of Elsevier.

The editors would like to thank the many
members of the ESC Congress 2016
presenting faculty who generously gave
their time to ensure the accuracy and
quality of the articles in this publication

presenting with incessant VT or electrical storm, ischemic heart disease, and recurrent ICD shocks due to
sustained VT [Priori SG et al. Eur Heart J. 2015]. Catheter
ablation should be considered after a first episode of sustained VT in patients with ischemic heart disease and an
ICD. A study in VT patients with a history of MI showed
that prophylactic VT ablation before ICD seemed to
increase the time to recurrent VT in patients with stable
VT, previous MI, and reduced LVEF (Figure 2) [Kuck KH
et al. Lancet. 2010].
The management of VT is dependent on the substrate,
which can be very heterogeneous. Although ICDs are
still the major treatment for secondary prevention of VT,
catheter ablation is playing an increasing role.

October 2016

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