Abstract 10937: Meta-Analysis of Catheter Ablation for Treatment of Ventricular Tachycardia
Objective: To define the relative risk of ventricular tachycardia recurrence after catheter ablation versus medical therapy in a pooled analysis of controlled studies.
Background: Most studies of catheter ablation for treatment of ventricular tachycardia are relatively small and uncontrolled observational trials.
Methods: Randomized and non-randomized controlled trials of patients who underwent catheter ablation of ventricular tachycardia versus medical therapy were sought. MEDLINE, EMBASE, the Cochrane Central register of controlled trials (CENTRAL), and Web of Science were searched from 1965 to January 2010. Supplemental searches included Internet resources, reference lists, and reports of arrhythmia experts. Three authors independently reviewed and extracted the data regarding baseline characteristics, allocation groups, ablation methodology, complications, ventricular tachycardia recurrences, mortality, and study quality.
Results: Five studies (2 published randomized controlled trials, 2 randomized controlled trials published as abstracts, and one non randomized study with a control group) were included totaling 457 participants with structural heart disease. Catheter ablation was performed in 266 (58%) participants whereas 191 (42%) received medical therapy for ventricular tachycardia. Complications of catheter ablation included death (1%), stroke (1%), cardiac perforation (1%), and complete heart block (1.6%). Ventricular tachycardia recurrences occurred in 93 (35%) patients who underwent catheter ablation versus 105 (55%) patients who received medical therapy. During follow-up, death occurred in 20 (11.5%) patients allocated to catheter ablation compared to 19 (13.6%) patients on medical therapy. Using a random effects model, a statistically significant 35% reduction in ventricular tachycardia recurrences was noted among patients with catheter ablation (relative risk 0.65; 95% confidence interval: 0.54 — 0.79, P < 0.001). There was no statistically significant difference in mortality.
Conclusion: Catheter ablation reduces ventricular tachycardia recurrences in patients with structural heart disease and has no impact on mortality.
- © 2010 by American Heart Association, Inc.