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Katarina Vizar Cisarova

Julia Mader

Kathrin Eller

Nadia Dandachi

Philipp Bosch

Othmar Moser

Sebastian Vosberg

Michael Dengler

Rainer Schindl

Philipp Jost

Daniel Scherr

Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Santoro, F; Mugnai, G; Perrotta, L; Kovacs, B; Dinshaw, L; Del, Castillo, AM; Jungen, C; Kurath-Koller, S; Stojković, S; Vandenberk, B; Vernooy, K.
Catheter ablation vs. anti-arrhythmic drug therapy for ventricular tachycardia in ischaemic heart disease: a meta-analysis of randomized controlled trials.
Europace. 2025; 27(12): Doi: 10.1093/europace/euaf302 [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Kurath-Koller Stefan
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Abstract:: AIMS: Ventricular tachycardia (VT) in ischaemic heart disease (IHD) requires complex management strategies including catheter ablation (CA) and anti-arrhythmic drugs (AADs). The aim of this study is to compare efficacy and safety of CA vs. AADs in patients with IHD and VT. METHODS AND RESULTS: We performed a meta-analysis of randomized controlled trials (RCTs) enrolling patients with IHD and ICD randomized to CA or AADs. Primary outcome was appropriate ICD therapy. Secondary outcomes included inappropriate ICD therapy, cardiovascular (CV) re-hospitalization, all-cause/CV mortality, and adverse events. Subgroup analyses were conducted for amiodarone and sotalol, with an exploratory evaluation of a composite endpoint (ICD shock, VT storm, all-cause death). Four RCTs including 947 patients (mean age 68 ± 2 years; 93% male) were analysed. CA significantly reduced the risk of appropriate ICD therapy compared with AADs (149/470 [31.7%] vs. 229/477 [48.0%]; RR 0.81; 95% CI [0.67, 0.97]; P = 0.02). Among secondary outcomes, CA decreased the incidence of CV re-hospitalization [RR 0.84; 95% CI (0.72, 0.99); P = 0.04] and adverse events [RR 0.42; 95% CI (0.28, 0.62); P < 0.01], while no differences were observed in all-cause/CV mortality and inappropriate ICD therapy. In subgroup analyses, CA was superior to sotalol in reducing the composite endpoint of ICD shock, VT storm and all-cause death [RR: 0.82, 95% CI (0.69, 0.98), P = 0.03]; whereas, no significant benefit was seen compared to amiodarone [RR: 0.92; 95% CI (0.78, 1.09), P = 0.32]. CONCLUSION: In ischaemic heart disease and VT, CA compared with anti-arrhythmic drugs is associated with a reduction of appropriate ICD therapy, cardiovascular re-hospitalization, and adverse events with benefits most evident versus sotalol.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Anti-Arrhythmia Agents - therapeutic use, adverse effects; Tachycardia, Ventricular - therapy, mortality, physiopathology, diagnosis, etiology; Randomized Controlled Trials as Topic - administration & dosage; Myocardial Ischemia - complications, mortality, therapy, diagnosis; Catheter Ablation - adverse effects, mortality; Male - administration & dosage; Aged - administration & dosage; Defibrillators, Implantable - administration & dosage; Treatment Outcome - administration & dosage; Female - administration & dosage; Risk Factors - administration & dosage; Sotalol - therapeutic use; Middle Aged - administration & dosage
Find related publications in this database (Keywords): Ventricular tachycardia; Catheter ablation; Anti-arrhythmic drugs; Amiodarone; Sotalol; Implantable cardioverter-defibrillator; Ischaemic cardiomyopathy; Re-hospitalization