Ventricular Tachycardia Clinical Trial
Official title:
Ventricular Tachycardia in Ischemic Cardiomyopathy; a Combined Endo-Epicardial Ablation Within the First Procedure Versus a Stepwise Approach a Randomized Controlled Trial
Rationale: Nowadays ventricular tachycardia (VT) ablation in structural heart disease is
performed primarily by early referral; while at the same time we still struggle with the
limited longterm ablation success of endocardial VT ablation. An underestimated number of
VTs from ischemic substrate have an epicardial exit. However, one cannot accurately predict
who is in need of epicardial ablation. The investigators hypothesise endo/epicardial
substrate homogenization in a first approach to be superior to endocardial substrate
homogenization alone, in terms of recurrence on follow-up.
Objective: To show superiority of a combined endo/epicardial approach compared to a stepwise
approach in the ablation of ventricular tachycardia in a population with ischemic
cardiomyopathy on VT recurrence.
Study design: Multicenter prospective open randomized controlled trial. Study population:
All patients above 18 years with an ischemic cardiomyopathy being referred for a ventricular
tachycardia ablation.
Intervention: One group undergoes endo/epicardial ablation and the other group has
endocardial ablation only as a first approach.
Main study parameters/endpoints: The main study endpoint is the difference in recurrences of
ventricular tachycardia on follow-up - clinical or on implantable cardioverter defibrillator
(ICD) interrogation - between the two ablation groups; secondary endpoints are procedure
success and safety.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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