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Catheter Ablation versus Medical Therapy for Ventricular Tachycardia in Patients with Ischemic Heart Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Khan, Ubaid Khlidj, Yehya Ibrahim, Ahmed A. Amin, Ahmed Mazen Rakab, Mohamed Saad AlBarakat, Majd M. Khan, Muhammad Haris Majeed, Zuhair Imran, Muhammad Ali, Junaid
Khan, Ubaid
Khlidj, Yehya
Ibrahim, Ahmed A.
Amin, Ahmed Mazen
Rakab, Mohamed Saad
AlBarakat, Majd M.
Khan, Muhammad Haris
Majeed, Zuhair
Imran, Muhammad
Ali, Junaid
Supervisor
Department
Computer Vision
Embargo End Date
Type
Journal article
Date
2025
License
Language
English
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Research Projects
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Journal Issue
Abstract
Background
Ventricular tachycardia (VT) is a common chronic complication of ischemic heart disease (IHD), even in the era of contemporary coronary intervention. The use of implantable cardioverter-defibrillators (ICDs) has reduced mortality, but ICD shocks can be painful and traumatizing. Catheter ablation has been posited to reduce VT incidence and is commonly used in IHD patients when antiarrhythmic drugs do not suppress VT.
Purpose
We aim to review the clinical efficacy and safety of catheter ablation vs medical therapy in patients with IHD.
Methods
We conducted comprehensive searches across PubMed, CENTRAL, Web of Science, Scopus, and Embase until May 2024. Pooled data were reported using risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes. This systematic review and meta-analysis was registered with PROSPERO ID: CRD42024551760.
Results
We included eight RCTs with a total of 1252 patients. Patients who underwent catheter ablation had a lower risk of VT storms compared to those who received medical therapy alone [RR: 0.74 with 95 % CI: (0.60, 0.91), P = 0.005), Compared to medical therapy, the catheter ablation group also required less appropriate ICD therapy [RR: 0.72 with 95 % CI: (0.57, 0.90), P = 0.005), and fewer appropriate ICD shocks [RR: 0.75 with 95 % CI: (0.57, 0.99), P = 0.04). However, there was no significant difference in Ventricular tachycardia/Ventricular fibrillation (VT/VF) recurrence [RR: 0.94 with 95 % CI: (0.83, 1.06), P = 0.33) and all-cause mortality [RR: 0.87 with 95 % CI: (0.70, 1.09), P = 0.22).
Conclusion
Catheter ablation is associated with a significant reduction in ventricular storms, appropriate ICD therapy, and appropriate ICD shocks while demonstrating similar safety in managing VT in IHD patients compared to medical therapy alone.
Citation
U. Khan et al., “Catheter ablation versus medical therapy for ventricular tachycardia in patients with ischemic heart disease: A systematic review and meta-analysis of randomized controlled trials,” Indian Pacing Electrophysiol J, vol. 25, no. 2, pp. 91–103, Mar. 2025, doi: 10.1016/J.IPEJ.2025.03.004
Source
Indian Pacing and Electrophysiology Journal
Conference
Keywords
Ventricular tachycardia, Ischemic heart disease, Catheter ablation, Intracardiac cardioverter defibrillator, Meta-analysis
Subjects
Source
Publisher
Elsevier