Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia

Status:	Terminated
Conditions:	Cardiology
Therapuetic Areas:	Cardiology / Vascular Diseases
Healthy:	No
Age Range:	19 - 84
Updated:	10/14/2017
Start Date:	August 2010
End Date:	December 2014

Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia: A Multi-center Randomized Trial

Implantable Cardioverter Defibrillators (ICDs) provide a shock or pacing therapy to bring
back a normal heart beat when a patient experiences a dangerous abnormal heart rhythm such as
ventricular tachycardia (VT). ICDs are very successful in bringing back a normal heart beat
when VT occurs, but they do not prevent further dangerous heart rhythms from occurring. This
study is designed to determine the best way to manage patients who have an ICD and who
continue to have episodes of VT. There are two methods for treatment the VT: 1) Ablation, and
2) Medication.

An ablation procedure involves placing a flexible catheter (insulated wire) in the groin area
and threading it into the heart. After the doctor has located the affected area responsible
for the VT, radiofrequency energy is delivered by the power generator through the catheter to
the inside of the heart. The radiofrequency energy ablates (burns) a small area of the heart
tissue thought to cause the VT.

A medication called Amiodarone is an "anti-arrhythmic" prescribed to prevent abnormal heart
rhythms from recurring.

The purpose of this study is to compare these two different methods for treating VT.
Treatment with ablation and amiodarone are both considered the standard of care for patients
with VT but they have not been compared directly in a study like this before.

Inclusion Criteria - Patients must meet all of the following criteria:

- > 18 and < 85 years of age

- ICD implanted for primary prophylaxis against sudden cardiac death or ICD implanted
for secondary prophylaxis against spontaneous or inducible sustained VT without any
reversible causes

- CAD with prior MI

- ICD or ECG documentation of ventricular arrhythmia responsible for appropriate ICD
therapy [ATP & shocks].

Exclusion Criteria - Patients should not have any of the following criteria:

- Contraindication or allergy to contrast media, routine procedural medications or
catheter materials

- Contraindication to an interventional procedure

- Current or previous (within 3 months) amiodarone therapy

- Atrial Fibrillation requiring antiarrhythmic drug therapy

- Contraindication to amiodarone therapy

- New York Heart Association (NYHA) functional class IV

- Myocardial infarction within the past 60 days

- Stroke within the past 90 days

- Unstable angina

- Hypertrophic cardiomyopathy, Non-ischemic dilated cardiomyopathy, Arrhythmogenic Right
Ventricular Dysplasia, Brugada Syndrome, Catecholamine sensitive polymorphic VT or
long QT syndrome

- Patients with active ischemia that are eligible for revascularization

- Life expectancy less than 6 months

- Incessant or multiple episodes of VT requiring immediate therapy with medications or
ablation

- Untreated hypothyroidism or hyperthyroidism. Patients who are euthyroid on thyroid
hormone replacement therapy are acceptable.

- Current enrollment in another investigational drug or device study.

- Presence of any other condition that the investigator feels would be problematic or
would restrict or limit the participation of the patient for the entire study period.

- Absolute contra-indication to the use of heparin and or warfarin.

- Documented intra-atrial thrombus, ventricular thrombus (< 6 months after detection of
thrombus), tumor, or another abnormality which precludes catheter introduction.

- Females of childbearing potential who are not practicing protocol acceptable method of
birth control.

We found this trial at

sites

Hospital of the University of Pennsylvania

3400 Spruce St
Philadelphia, Pennsylvania 19104

(215) 662-4000