Impact of early ventricular tachycardia ablation in patients with an implantable cardioverter-defibrillator: An updated systematic review and meta-analysis of randomized controlled trials
There is limited information on whether early catheter ablation (CA) for ventricular tachycardia (VT) is associated with better outcomes compared with alternative strategies in patients with implantable cardioverter-defibrillator (ICD). The purpose of this article was to assess the efficacy of early...
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Published in | Heart rhythm Vol. 19; no. 12; pp. 2054 - 2061 |
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Abstract | There is limited information on whether early catheter ablation (CA) for ventricular tachycardia (VT) is associated with better outcomes compared with alternative strategies in patients with implantable cardioverter-defibrillator (ICD).
The purpose of this article was to assess the efficacy of early VT CA in patients with ICD.
EMBASE, PubMed, and Cochrane were searched from inception to April 2022. Randomized controlled trials comparing the efficacy of early VT CA with control groups, both in patients with ICD, were included in the analysis. Data on effect estimates in individual studies were extracted and combined via random effects meta-analysis using the DerSimonian and Laird method, a generic inverse variance strategy.
Nine randomized controlled trials with 1106 patients (n = 1018, 92.1% with ischemic cardiomyopathy and n = 88, 7.9% with nonischemic cardiomyopathy) were evaluated. VT CA was associated with reduced VT recurrences (odds ratio [OR] 0.64; P = .007), appropriate ICD shocks (OR 0.53; P = .002), ICD therapies (OR 0.54; P = .002), and cardiovascular hospitalization (OR 0.67; P = .004). However, no significant differences were observed in terms of mortality rate, heart failure hospitalization, and quality of life between the early VT CA and control groups.
Early CA was beneficial in reducing VT burden and ICD therapies. However, it did not affect mortality rate and quality of life. Since most patients in the included studies presented with ischemic cardiomyopathy, further studies on nonischemic cardiomyopathy should be conducted to validate if early CA has similar outcomes. |
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AbstractList | There is limited information on whether early catheter ablation (CA) for ventricular tachycardia (VT) is associated with better outcomes compared with alternative strategies in patients with implantable cardioverter-defibrillator (ICD).
The purpose of this article was to assess the efficacy of early VT CA in patients with ICD.
EMBASE, PubMed, and Cochrane were searched from inception to April 2022. Randomized controlled trials comparing the efficacy of early VT CA with control groups, both in patients with ICD, were included in the analysis. Data on effect estimates in individual studies were extracted and combined via random effects meta-analysis using the DerSimonian and Laird method, a generic inverse variance strategy.
Nine randomized controlled trials with 1106 patients (n = 1018, 92.1% with ischemic cardiomyopathy and n = 88, 7.9% with nonischemic cardiomyopathy) were evaluated. VT CA was associated with reduced VT recurrences (odds ratio [OR] 0.64; P = .007), appropriate ICD shocks (OR 0.53; P = .002), ICD therapies (OR 0.54; P = .002), and cardiovascular hospitalization (OR 0.67; P = .004). However, no significant differences were observed in terms of mortality rate, heart failure hospitalization, and quality of life between the early VT CA and control groups.
Early CA was beneficial in reducing VT burden and ICD therapies. However, it did not affect mortality rate and quality of life. Since most patients in the included studies presented with ischemic cardiomyopathy, further studies on nonischemic cardiomyopathy should be conducted to validate if early CA has similar outcomes. BACKGROUNDThere is limited information on whether early catheter ablation (CA) for ventricular tachycardia (VT) is associated with better outcomes compared with alternative strategies in patients with implantable cardioverter-defibrillator (ICD). OBJECTIVEThe purpose of this article was to assess the efficacy of early VT CA in patients with ICD. METHODSEMBASE, PubMed, and Cochrane were searched from inception to April 2022. Randomized controlled trials comparing the efficacy of early VT CA with control groups, both in patients with ICD, were included in the analysis. Data on effect estimates in individual studies were extracted and combined via random effects meta-analysis using the DerSimonian and Laird method, a generic inverse variance strategy. RESULTSNine randomized controlled trials with 1106 patients (n = 1018, 92.1% with ischemic cardiomyopathy and n = 88, 7.9% with nonischemic cardiomyopathy) were evaluated. VT CA was associated with reduced VT recurrences (odds ratio [OR] 0.64; P = .007), appropriate ICD shocks (OR 0.53; P = .002), ICD therapies (OR 0.54; P = .002), and cardiovascular hospitalization (OR 0.67; P = .004). However, no significant differences were observed in terms of mortality rate, heart failure hospitalization, and quality of life between the early VT CA and control groups. CONCLUSIONEarly CA was beneficial in reducing VT burden and ICD therapies. However, it did not affect mortality rate and quality of life. Since most patients in the included studies presented with ischemic cardiomyopathy, further studies on nonischemic cardiomyopathy should be conducted to validate if early CA has similar outcomes. |
Author | Navaravong, Leenhapong Prasitlumkum, Narut Cheungpasitporn, Wisit Chokesuwattanaskul, Ronpichai Bunch, T. Jared Jongnarangsin, Krit Desai, Aditya Desai, Darshi Rattanawong, Pattara |
Author_xml | – sequence: 1 givenname: Narut orcidid: 0000-0002-7956-0574 surname: Prasitlumkum fullname: Prasitlumkum, Narut organization: Department of Cardiology, University of California Riverside, Riverside, California – sequence: 2 givenname: Leenhapong surname: Navaravong fullname: Navaravong, Leenhapong organization: Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah – sequence: 3 givenname: Aditya surname: Desai fullname: Desai, Aditya organization: Department of Internal Medicine, University of California Riverside, Riverside, California – sequence: 4 givenname: Darshi surname: Desai fullname: Desai, Darshi organization: Department of Internal Medicine, University of California Riverside, Riverside, California – sequence: 5 givenname: Wisit surname: Cheungpasitporn fullname: Cheungpasitporn, Wisit organization: Department of Medicine, Mayo Clinic, Rochester, Minnesota – sequence: 6 givenname: Pattara surname: Rattanawong fullname: Rattanawong, Pattara organization: Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona – sequence: 7 givenname: T. Jared surname: Bunch fullname: Bunch, T. Jared organization: Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah – sequence: 8 givenname: Krit surname: Jongnarangsin fullname: Jongnarangsin, Krit organization: Division of Cardiovascular Medicine, Frankel Cardiovascular Center, University of Michigan Health, Ann Arbor, Michigan – sequence: 9 givenname: Ronpichai surname: Chokesuwattanaskul fullname: Chokesuwattanaskul, Ronpichai email: drronpichaic@gmail.com organization: Division of Cardiovascular Medicine, Department of Medicine, Cardiac Center, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand |
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CitedBy_id | crossref_primary_10_1016_j_hrthm_2024_05_018 crossref_primary_10_1007_s10840_023_01502_2 crossref_primary_10_1016_j_hroo_2022_12_005 crossref_primary_10_1016_j_jacep_2022_11_004 crossref_primary_10_1016_j_hrthm_2022_07_024 crossref_primary_10_3390_bioengineering10121386 crossref_primary_10_3390_jcdd10040172 crossref_primary_10_1007_s10840_023_01574_0 crossref_primary_10_1093_europace_euae066 crossref_primary_10_1111_jce_16292 crossref_primary_10_1007_s11897_023_00642_w |
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Snippet | There is limited information on whether early catheter ablation (CA) for ventricular tachycardia (VT) is associated with better outcomes compared with... BACKGROUNDThere is limited information on whether early catheter ablation (CA) for ventricular tachycardia (VT) is associated with better outcomes compared... |
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SubjectTerms | Ablation Cardiomyopathies - complications Catheter Ablation - methods Defibrillators, Implantable - adverse effects Early Humans Meta-analysis Myocardial Ischemia - complications Outcomes Quality of Life Randomized Controlled Trials as Topic Tachycardia, Ventricular - surgery Treatment Outcome Ventricular tachycardia |
Title | Impact of early ventricular tachycardia ablation in patients with an implantable cardioverter-defibrillator: An updated systematic review and meta-analysis of randomized controlled trials |
URI | https://dx.doi.org/10.1016/j.hrthm.2022.07.005 https://www.ncbi.nlm.nih.gov/pubmed/35820619 https://search.proquest.com/docview/2689059304 |
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