title: Outcomes of a single centre registry of patients with ischaemic heart disease, qualified for an RF ablation of ventricular arrhythmia after ICD intervention.
abstract: OBJECTIVE
  Reduction of ICD interventions improves the quality of life and possibly reduces mortality. Ablation reduces ICD interventions in patients with ablatable arrhythmia, but its effectiveness needs to be proven for patients with coronary artery disease (CAD) regardless of the type of arrhythmia. Our study was designed to address this issue, but it had to be terminated due to recruitment problems. The reasons for early termination are described in this paper.
  
  
  METHODS
  Patients with CAD and implanted ICD, who within the past three months survived an episode of VT/VF, were selected for this study. Patients were to be randomised for ablation or pharmacotherapy. A group of 209 patients was screened between June and December of 2007.
  
  
  RESULTS
  Out of 209 patients, 39 (18.7%) had appropriate ICD therapy during the last three months and were potentially eligible for the trial. Out of 39 patients, 34 could not be randomised, due to the presence of exclusion criteria (n-25) or consent refusal (n-9). Previous ablation (n-10), left ventricular thrombus (n-3) or presence of mitral or aortic artificial valve (n-3) were the most frequent exclusion criteria. During follow-up of 12 months one patient required ablation due to frequent ICD discharges. From the five randomised patients, two were randomised to ablation and three to the pharmacotherapy arm.
  
  
  CONCLUSIONS
  1. Ablation might not be suitable as a routine treatment for all patients with ICD interventions, as a significant group prefers not to undergo RF ablation as a routine treatment or there are contraindications for the ablation. 2. There are obstacles in prospective and randomised evaluation of the role of ablation in patients with CAD and ICD interventions, which are related both to patients' medical conditions and to patients' will. These limitations should be taken into account when designing further studies.
authors.affiliation: Instytut Kardiologii, ul. Alpejska 42, 04-628 Warszawa. lszumowski@ikard.pl
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Szumowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Przybylski
authors.forename: Aleksander
authors.initials: A
authors.lastname: Maciag
authors.forename: Paweł
authors.initials: P
authors.lastname: Derejko
authors.forename: Robert
authors.initials: R
authors.lastname: Bodalski
authors.forename: Joanna
authors.initials: J
authors.lastname: Zakrzewska
authors.forename: Michał
authors.initials: M
authors.lastname: Orczykowski
authors.forename: Ewa
authors.initials: E
authors.lastname: Szufladowicz
authors.forename: Hanna
authors.initials: H
authors.lastname: Szwed
authors.forename: Franciszek
authors.initials: F
authors.lastname: Walczak
mesh_terms: D000368:Aged; D017115:Catheter Ablation; D000075202:Contraindications; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications* / Q000628:therapy; D012042:Registries; D012107:Research Design; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome