VT Ablation: Survival Free from ICD Therapy

William Stevenson; David Wilber; Vivek Reddy

VT Ablation: Survival Free from ICD Therapy

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Date: January 16, 2012

Roundtable ID: CV6748

Citation: Med Roundtable Cardiovasc Ed. ; 3(2): 130 - 136.

Summary:
Vivek Reddy from the Mount Sinai Hospital, New York, NY moderated the topic "VT Ablation: Survival Free from ICD Therapy" with Drs. William Stevenson from Brigham and Women's Hospital, Boston, MA, and David Wilber from Loyola University Medical Center, Maywood, IL.

The discussion focused primarily on:

(1) Treating VT using catheter mapping and ablation;

(2) the evolution of ablation therapy to a substrate based approach;

(3) the complications of VT ablation;

(4) the late referral of patients;

(5) additional improvements in catheter ablation; and

(6) treating atients who have VT in the setting of a structurally-normal heart.

(Med Roundtable Cardiovasc Ed. 2012;3(2):130-136) ©2012 FoxP2 Media, LLC

Compounds:
amiodarone, mexiletine

Trials:
SMASH-VT, VTACH

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"Certainly, the procedure is performed safely in this study. There were no significant adverse events... In fact, there were fewer events, albeit ... significant in terms of the overall mortality."
~ Vivek Reddy, MD

"There were a number of single center studies implying a variety of approaches ... that showed that in individual centers you could have ... success rates in the 70% to 80% range in terms of preventing VT."
~ William Stevenson, MD

"The modern day approach occasionally includes mapping during VT but also includes a sinus rhythm-based approach that doesn’t require patients to be in tachycardia ... and can give results that were very similar to the kinds of results that could be achieved with mapping during stable VT alone. "
~ David Wilber, MD