Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials.
TM, F., AIG, P., MFC, G., ET, M., JVJ, R., & LA, M. (2026). Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials.. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working grou. https://doi.org/10.1093/europace/euag073
TM F, AIG P, MFC G, ET M, JVJ R, LA M. Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials.. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working grou. 2026; doi: 10.1093/europace/euag073
TM F, AIG P, MFC G, et al. Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials.[J]. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working grou. 2026. DOI: 10.1093/europace/euag073.
@article{tm2026,
author = {Façanha TM and Pereira AIG and Garcia MFC and Mendonça ET and Ramos JVJ and Mesquita LA},
title = {Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials.},
journal = {Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working grou},
year = {2026},
doi = {10.1093/europace/euag073},
note = {PMID: 42357807},
}
TY - JOUR AU - Façanha TM AU - Pereira AIG AU - Garcia MFC AU - Mendonça ET AU - Ramos JVJ AU - Mesquita LA TI - Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials. T2 - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working grou PY - 2026 DO - 10.1093/europace/euag073 AN - PMID:42357807 ER -
INTRODUCTION: Antiarrhythmic drugs (AADs) have traditionally been used as first-line therapy for ventricular tachycardia (VT) but are frequently associated with systemic toxicities and drug interactions. Therefore, we performed a meta-analysis comparing early catheter ablation (CA) with AAD therapy as initial treatment for VT in patients with prior myocardial infarction. METHODS AND RESULTS: PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials comparing CA vs. AAD in patients naïve to both strategies. Meta-analysis was performed using Review Manager. Three randomized trials including 618 patients were analysed. No significant differences were observed in all-cause mortality, appropriate implantable cardioverter-defibrillator (ICD) therapies (including shocks and antitachycardia pacing), ventricular arrhythmia storm, hospitalizations, or adverse events between strategies. Leave-one-out sensitivity analysis identified one trial as the primary contributor to between-study heterogeneity. CONCLUSION: Early catheter ablation provides similar efficacy to first-line antiarrhythmic drug therapy for major arrhythmic and survival outcomes, with reductions in hospitalizations and treatment-related adverse events, although largely driven by one trial. These findings support consideration of CA as a first-line therapeutic strategy in selected patients with ischaemic VT.