TY - JOUR
T1 - A Prospective, Multicentre Randomised Controlled Trial Comparing Catheter Ablation Versus Antiarrhythmic Drugs in Patients With Structural Heart Disease Related Ventricular Tachycardia
T2 - The CAAD-VT Trial Protocol
AU - CAAD-VT investigators;
AU - Bennett, Richard G.
AU - Campbell, Timothy
AU - Garikapati, Kartheek
AU - Kotake, Yasuhito
AU - Turnbull, Samual
AU - Kanawati, Juliana
AU - Wong, Mary S.
AU - Qian, Pierre
AU - Thomas, Stuart P.
AU - Chow, Clara K.
AU - Kovoor, Pramesh
AU - Robert Denniss, A.
AU - Chik, William
AU - Marschner, Simone
AU - Kistler, Peter
AU - Haqqani, Haris
AU - Rowe, Matthew
AU - Voskoboinik, Aleksandr
AU - Lee, Geoffrey
AU - Jackson, Nicholas
AU - Sanders, Prashanthan
AU - Roberts-Thomson, Kurt
AU - Chan, Kim Hoe
AU - Sy, Raymond
AU - Pathak, Rajeev
AU - Kanagaratnam, Logan
AU - Chia, Karin
AU - El-Sokkari, Ihab
AU - Hallani, Hisham
AU - Kanthan, Ajita
AU - Burgess, David
AU - Kumar, Saurabh
N1 - Publisher Copyright:
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)
PY - 2023/2
Y1 - 2023/2
N2 - Importance: Randomised trials have shown that catheter ablation (CA) is superior to medical therapy for ventricular tachycardia (VT) largely in patients with ischaemic heart disease. Whether this translates to patients with all forms and stages of structural heart disease (SHD—e.g., non-ischaemic heart disease) is unclear. This trial will help clarify whether catheter ablation offers superior outcomes compared to medical therapy for VT in all patients with SHD. Objective: To determine in patients with SHD and spontaneous or inducible VT, if catheter ablation is more efficacious than medical therapy in control of VT during follow-up. Design: Randomised controlled trial including 162 patients, with an allocation ratio of 1:1, stratified by left ventricular ejection fraction (LVEF) and geographical region of site, with a median follow-up of 18-months and a minimum follow-up of 1 year. Setting: Multicentre study performed in centres across Australia. Participants: Structural heart disease patients with sustained VT or inducible VT (n=162). Intervention: Early treatment, within 30 days of randomisation, with catheter ablation (intervention) or initial treatment with antiarrhythmic drugs only (control). Main outcomes, measures, and results: Primary endpoint will be a composite of recurrent VT, VT storm (≥3 VT episodes in 24 hrs or incessant VT), or death. Secondary outcomes will include each of the individual primary endpoints, VT burden (number of VT episodes in the 6 months preceding intervention compared to the 6 months after intervention), cardiovascular hospitalisation, mortality (including all-cause mortality, cardiac death, and non-cardiac death) and LVEF (assessed by transthoracic echocardiography from baseline to 6-, 12-, 24- and 36-months post intervention). Conclusions and Relevance: The Catheter Ablation versus Anti-arrhythmic Drugs for Ventricular Tachycardia (CAAD-VT) trial will help determine whether catheter ablation is superior to antiarrhythmic drug therapy alone, in patients with SHD-related VT. Trial Registry: Australian New Zealand Clinical Trials Registry (ANZCTR) Trial Registration ID: ACTRN12620000045910 Trial Registration URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377617&isReview=true
AB - Importance: Randomised trials have shown that catheter ablation (CA) is superior to medical therapy for ventricular tachycardia (VT) largely in patients with ischaemic heart disease. Whether this translates to patients with all forms and stages of structural heart disease (SHD—e.g., non-ischaemic heart disease) is unclear. This trial will help clarify whether catheter ablation offers superior outcomes compared to medical therapy for VT in all patients with SHD. Objective: To determine in patients with SHD and spontaneous or inducible VT, if catheter ablation is more efficacious than medical therapy in control of VT during follow-up. Design: Randomised controlled trial including 162 patients, with an allocation ratio of 1:1, stratified by left ventricular ejection fraction (LVEF) and geographical region of site, with a median follow-up of 18-months and a minimum follow-up of 1 year. Setting: Multicentre study performed in centres across Australia. Participants: Structural heart disease patients with sustained VT or inducible VT (n=162). Intervention: Early treatment, within 30 days of randomisation, with catheter ablation (intervention) or initial treatment with antiarrhythmic drugs only (control). Main outcomes, measures, and results: Primary endpoint will be a composite of recurrent VT, VT storm (≥3 VT episodes in 24 hrs or incessant VT), or death. Secondary outcomes will include each of the individual primary endpoints, VT burden (number of VT episodes in the 6 months preceding intervention compared to the 6 months after intervention), cardiovascular hospitalisation, mortality (including all-cause mortality, cardiac death, and non-cardiac death) and LVEF (assessed by transthoracic echocardiography from baseline to 6-, 12-, 24- and 36-months post intervention). Conclusions and Relevance: The Catheter Ablation versus Anti-arrhythmic Drugs for Ventricular Tachycardia (CAAD-VT) trial will help determine whether catheter ablation is superior to antiarrhythmic drug therapy alone, in patients with SHD-related VT. Trial Registry: Australian New Zealand Clinical Trials Registry (ANZCTR) Trial Registration ID: ACTRN12620000045910 Trial Registration URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377617&isReview=true
KW - Antiarrhythmic drugs
KW - Catheter ablation
KW - Structural heart disease
KW - Ventricular arrhythmia
KW - Ventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=85146016366&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2022.09.006
DO - 10.1016/j.hlc.2022.09.006
M3 - Article
C2 - 36599791
AN - SCOPUS:85146016366
SN - 1443-9506
VL - 32
SP - 184
EP - 196
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 2
ER -