{Reference Type}: Journal Article
{Title}: Prophylactic Catheter Ablation of Ventricular Tachycardia in Ischemic Cardiomyopathy: a systematic review and meta-analysis of randomized controlled trials Electrophysiology Collaborative Consortium for Metaanalysis - ELECTRAM Investigators.
{Author}: Shah K;Turagam M;Patel B;Natale A;Lakkireddy D;Garg J;
{Journal}: J Atr Fibrillation
{Volume}: 13
{Issue}: 2
{Year}: Aug 2020
暂无{DOI}: 10.4022/jafib.2371
{Abstract}: <B>OBJECTIVE: </B>Catheter ablation is an effective strategy for drug-refractory ventricular tachycardia (VT) in ischemic cardiomyopathy. We aimed to perform a systematic review and meta-analysis of outcomes of prophylactic catheter ablation (PCA) of Ventricular Tachycardia (VT) in ischemic cardiomyopathy patients.<BR><B>METHODS: </B>We performed a comprehensive literature search through February 10, 2020, for all eligible randomized controlled trials that compared "PCA" versus "No PCA" for VT. Primary efficacy outcomes included - appropriate ICD therapy (composite of anti-tachycardia pacing and ICD shock), appropriate ICD shocks, electrical storm, cardiac mortality, and all-cause mortality. The primary safety outcome was any adverse events.<BR><B>RESULTS: </B>Four randomized controlled trials (N = 505) met inclusion criteria. Prophylactic catheter ablation was associated significant reduction in appropriate ICD therapies (RR 0.70; 95% CI 0.55 - 0.89, p = 0.004), appropriate ICD shocks (RR 0.57 95% CI 0.40 - 0.80, p = 0.001) with a trend towards reduced risk of electrical storm (RR 0.64; CI 0.39 - 1.05; p = 0.075) compared to "No PCA". There was no significant difference in cardiac mortality (RR 0.66, 95% CI 0.31 - 1.43, p = 0.29) and all-cause mortality (RR 0.98, 95% CI 0.52 - 1.82, p = 0.94) with similar adverse events (RR 1.46, 95% CI 0.73 - 2.95, p = 0.29) between two groups.<BR><B>CONCLUSIONS: </B>Prophylactic catheter ablation in ischemic cardiomyopathy patients was associated with a lower risk of ICD therapies, including ICD shocks and VT storm with no difference in cardiac and all-cause mortality.