Does Timing of VT Ablation Affect Prognosis in Patients With an Implantable Cardioverter-defibrillator?
Does Timing of VT Ablation Affect Prognosis in Patients With an Implantable Cardioverter-defibrillator?
The purpose of this study is to assess whether the burden of untreated non-sustained
 ventricular tachycardias (VTs), or episodes treated with anti-tachycardia pacing, correlates
 with appropriate implantable cardiac defibrillator (ICD) shock therapies and to evaluate if
 the timing of radiofrequency VT ablation affects the prognosis of ICD recipients.
Enrolled patients will remain in a first phase of the study until the first appropriate ICD
 shock will be delivered.

 The objective of this first stage is to assess whether the burden of untreated non sustained
 VTs or episodes treated with anti-tachycardia pacing is predictive of appropriate ICD shocks.

 The second phase of the study will start after the first appropriate ICD shock delivered for
 VT.

 Patients will be then randomized to immediate VT ablation or to standard treatment, meaning
 waiting until next arrhythmic storm to perform a VT ablation procedure.

 The objective of this phase is compare the rate of worsening heart failure hospitalizations
 and deaths from any cause between the two groups.
Inclusion Criteria:

 -  Patients already implanted with ICD (single-/dual -chamber, with or without cardiac
 resynchronization therapy) for primary or secondary prevention of sudden cardiac death

 Exclusion Criteria:

 Phase A exclusion Criteria:

 -  General contraindication to transcatheter ablation

 -  Contraindication to antithrombotic therapy

 -  Patients chronically treated with class I and III antiarrhythmic drugs

 Phase B exclusion criteria:

 -  Patients developing first occurrence of incessant VTs

 -  Patients receiving a shock for first occurrence of clinically verified ventricular
 fibrillation

 -  Patients with aetiology differing from ischemic heart disease for coronary artery
 disease and from non-ischemic dilatative cardiomyopathy