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Catheter Ablation Reduces Defibrillator Shock Frequency

Reduces frequency better than an implantable defibrillator alone

WEDNESDAY, Dec. 26 (HealthDay News) -- Ablation of arrhythmic cardiac tissue combined with an implantable cardioverter-defibrillator (ICD) reduces the frequency of pacing and shocks better than an ICD alone in patients with a history of myocardial infarction, according to study findings published in the Dec. 27 issue of the New England Journal of Medicine.

Vivek Y. Reddy, M.D., from Massachusetts General Hospital in Boston, and colleagues randomly assigned 128 patients with a history of myocardial infarction to receive an ICD alone or combined with prophylactic radiofrequency catheter ablation of arrhythmogenic ventricular tissue.

During a mean follow-up of 22.5 months, the researchers found that significantly fewer patients who underwent catheter ablation received appropriate ICD therapy (antitachycardia pacing or shocks, 12 percent versus 33 percent, hazard ratio 0.35). Shocks were given in 31 percent of patients receiving an ICD alone and in 9 percent of patients who also underwent catheter ablation. Mortality rates were not significantly different between the two groups.

"In this randomized trial, prophylactic substrate-based catheter ablation reduced the incidence of ICD therapy in patients with a history of myocardial infarction who received ICDs for the secondary prevention of sudden death," Reddy and colleagues conclude.

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