Trial to Evaluate the Efficacy and Safety of Substrate Ablation of Monomorphic Ventricular Tachycardia
Trial to Evaluate the Efficacy and Safety of Substrate Ablation of Monomorphic Ventricular Tachycardia
To compare the efficacy and safety of substrate-based radiofrequency catheter ablation vs.
 antiarrhythmic drug therapy in patients with ischemic cardiomyopathy and scar-related
 sustained monomorphic ventricular tachycardia.
Sustained monomorphic ventricular tachycardia remains an important source of morbidity and
 mortality in patients surviving a myocardial infarction. ICD´s have been proven to reduce
 mortality in this patients population, nonetheless, recurrent arrhythmia and ICD shocks are
 known to negatively impact ventricular function and are associated with worsening heart
 failure and mortality. We devised a controlled, randomized, parallel, single blind, phase IV
 clinical trial with the aim of comparing the efficacy and safety of substrate-based
 radiofrequency catheter ablation vs. antiarrhythmic drug therapy in patients with ischemic
 cardiomyopathy and scar-related sustained monomorphic ventricular tachycardia, implanted with
 an ICD.
Inclusion Criteria:

 -  Ischemic cardiomyopathy, with ischemic myocardial scar

 -  Sustained monomorphic ventricular tachycardia

 -  Age > 18 years

 -  Prior ICD implantation

 Exclusion Criteria:

 -  VT storm

 -  NYHA functional class IV

 -  Additional indication for antiarrhythmic drug therapy

 -  Contraindication for both study drugs (amiodarone and sotalol).

 -  Uncontrolled myocardial ischemia.

 -  LV thrombus.

 -  Non-ischemic VT substrate.

 -  Contraindications for anticoagulation.

 -  Prior substrate ablation in the previous 6 months

 -  Cr > 2.5 mg/dL

 -  Mitral AND aortic mechanical valvular prosthesis