Ventricular Tachycardia (VT) Ablation or Escalated Drug Therapy

Summary

This study will compare aggressive antiarrhythmic therapy to catheter ablation for ventricular tachycardia in patients who have suffered prior myocardial infarction. The purpose of this study is to evaluate the optimal management of patients presenting with recurrent VT and receiving ICD therapy in spite of first-line antiarrhythmic drug therapy. The hypothesis is catheter ablation is superior to aggressive antiarrhythmic drug therapy for recurrent VT.

Conditions

• Recurrent Ventricular Tachycardia

Interventions

PROCEDURE

Catheter Ablation

Intracardiac electrode catheters are placed via central vasculature to identify myocardial scar, and surviving conduction channels within the scar which form the substrate for ventricular tachycardia. Radiofrequency energy is applied to these sites, interrupting the VT circuits.

DRUG

Escalated Antiarrhythmic Therapy

Patients who have 'failed' antiarrhythmic therapy (except amiodarone) will be prescribed: Amiodarone 400 mg twice daily for 2 weeks, followed by 400 mg/day for 4 weeks, followed by 200 mg/day thereafter. Patients who 'failed' amiodarone (less than 300mg/day) will be prescribed: Amiodarone 400 mg three times a day for 2 weeks, followed by 400 mg/day for 1 week and 300 mg/day thereafter. Patients who 'failed' amiodarone (greater or equal to 300mg/day) will be prescribed: Amiodarone at the current dose with the addition of mexiletine 400 to 800 mg/day

Sponsors & Collaborators

• Abbott Medical Devices

  collaborator INDUSTRY

• Biosense Webster, Inc.

  collaborator INDUSTRY

• Canadian Institutes of Health Research (CIHR)

  collaborator OTHER_GOV

• John Sapp

  lead OTHER

Principal Investigators

• John L Sapp, BSc, MD, FRCPC · Nova Scotia Health Authority

• Ratika Parkash, MD, MSc, FRCPC · Nova Scotia Health Authority

• Anthony S Tang, MSc, MD, FRCPC · Royal Jubilee Hospital

• George A Wells, BSc,MSc,PhD · Univeristy of Ottawa Heart Institute

• William G Stevenson, MD · Brigham and Women's Hospital

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2009-05-31

Primary Completion

2015-12-31

Completion

2015-12-31

Countries

• Canada

Study Locations