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Catheter Ablation Tops Escalation of Antiarrhythmic Meds

Findings in patients with ischemic cardiomyopathy, ICD with ventricular tachycardia despite meds

THURSDAY, May 5, 2016 (HealthDay News) — Catheter ablation is better than escalation of antiarrhythmic drugs for patients with ischemic cardiomyopathy and an implantable cardioverter-defibrillator (ICD) who have ventricular tachycardia despite use of antiarrhythmic drugs, according to a study published online May 5 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the Heart Rhythm Society, held from May 4 to 7 in San Francisco.

John L. Sapp, M.D., from Dalhousie University in Halifax, Canada, and colleagues randomized patients to receive catheter ablation with continuation of baseline antiarrhythmic medications (132 patients) or escalated antiarrhythmic drug therapy (escalated-therapy group; 127 patients).

The researchers found that the primary outcome of a composite of death, three or more documented episodes of ventricular tachycardia within 24 hours, or appropriate ICD shock occurred in 59.1 percent of patients in the ablation group and 68.5 percent of those in the escalated-therapy group, during a mean of 27.9 ± 17.1 months of follow-up (hazard ratio in the ablation group, 0.72). No significant differences were seen between the groups in mortality.

“In patients with ischemic cardiomyopathy and an ICD who had ventricular tachycardia despite antiarrhythmic drug therapy, there was a significantly lower rate of the composite primary outcome of death, ventricular tachycardia storm, or appropriate ICD shock among patients undergoing catheter ablation than among those receiving an escalation in antiarrhythmic drug therapy,” the authors write.

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