New Trial Result Pushes Past Antiarrhythmic Therapy After MI

Upfront catheter ablation is a better first-line strategy for patients who develop ventricular tachycardia (VT) after a myocardial infarction (MI) than waiting until antiarrhythmic drugs fail, a multicenter randomized trial shows.

At the end of follow up in the VANISH2 trial, upfront catheter ablation reduced the hazard ratio for a primary composite event outcome that included death by any cause, VT storm, shock from an implantable cardioverter defibrillator, and recurrent VT.

This study might upend typical practice. Drug therapy is currently the most common upfront approach and is guideline-recommended for post-MI VT; catheter ablation is typically reserved for second line.

 

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