The development of ventricular tachycardia (VT) in the setting of structural heart
disease (SHD) is a harbinger of doom. VT carries with it the obvious risk of sudden
arrhythmic death, which is largely mitigated by implantable cardioverter defibrillators
(ICDs). Yet these devices do not prevent or reduce VT, and the further effects of
VT have become clear in the ICD era. Recurrent ICD shocks are associated with increased
subsequent mortality,
1
and even recurrent antitachycardia pacing is associated with increased morbidity.2
Notably, the occurrence of VT dramatically increases the risk of new or decompensated
heart failure.3
Of utmost importance is the fact that recurrent ICD therapies are independently associated
with a reduced quality of life, increased anxiety, and reduced mental well-being.4
,5
These significant effects form the thrust of the search for better treatment of VT
in patients with SHD.To read this article in full you will need to make a payment
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References
- Prognostic importance of defibrillator shocks in patients with heart failure.N Engl J Med. 2008; 359: 1009-1017
- Association of antitachycardia pacing or shocks with survival in 69,000 patients with an implantable defibrillator.J Cardiovasc Electrophysiol. 2017; 28: 416-422
- Causes and consequences of heart failure after prophylactic implantation of a defibrillator in the Multicenter Automatic Defibrillator Implantation Trial II.Circulation. 2006; 113: 2810-2817
- Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocks.Circulation. 2002; 105: 589-594
- Quality of life in the Canadian Implantable Defibrillator Study (CIDS).Am Heart J. 2002; 144: 282-289
- 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society position statement on the management of ventricular tachycardia and fibrillation in patients with structural heart disease.Can J Cardiol. 2020; 36: 822-836
- 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias: executive summary.Heart Rhythm. 2020; 17: e155-e205
- Catheter ablation of ventricular arrhythmia in patients with an implantable cardioverter-defibrillator: a systematic review and meta-analysis.Can J Cardiol. 2022; (XX:xxx-xx)
- IPDfromKM: reconstruct individual patient data from published Kaplan-Meier survival curves.BMC Med Res Methodol. 2021; 21: 111
- Does timing of ventricular tachycardia ablation affect prognosis in patients with an implantable cardioverter defibrillator? Results from the multicenter randomized PARTITA trial.Circulation. 2022; 145: 1829-1838
- Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs.N Engl J Med. 2016; 375: 111-121
- Coronary bypass surgery with or without surgical ventricular reconstruction.N Engl J Med. 2009; 360: 1705-1717
- Percutaneous revascularization for ischemic left ventricular dysfunction.N Engl J Med. 2022; 387: 1351-1360
Article info
Publication history
Published online: January 09, 2023
Accepted:
January 6,
2023
Received:
December 29,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
See article by Fong et al., pages xxx-xxx of this issue.
See page 2 for disclosure information.
Identification
Copyright
© 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
