Impact of Substrate Modification by Catheter Ablation on Implantable Cardioverter–Defibrillator Interventions in Patients With Unstable Ventricular Arrhythmias and Coronary Artery Disease. Results From the Multicenter Randomized Controlled SMS (Substrate Modification Study)

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F17%3A00075933" target="_blank" >RIV/00023001:_____/17:00075933 - isvavai.cz</a>

Result on the web

<a href="http://circep.ahajournals.org/content/10/3/e004422" target="_blank" >http://circep.ahajournals.org/content/10/3/e004422</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1161/CIRCEP.116.004422" target="_blank" >10.1161/CIRCEP.116.004422</a>

Result language

angličtina

Original language name

Impact of Substrate Modification by Catheter Ablation on Implantable Cardioverter–Defibrillator Interventions in Patients With Unstable Ventricular Arrhythmias and Coronary Artery Disease. Results From the Multicenter Randomized Controlled SMS (Substrate Modification Study)

Original language description

Background-The implantable cardioverter-defibrillator (ICD) is the standard therapy to prevent sudden cardiac death in patients with coronary artery disease and unstable ventricular tachyarrhythmias. The prospective multinational SMS (Substrate Modification Study) was designed to assess whether prophylactic ablation of the arrhythmogenic substrate reduces or prevents the recurrence of ventricular tachycardia/ventricular fibrillation in such patients. Methods and Results-Of 111 patients included in an intention-to-treat analysis, 54 were randomly assigned catheter ablation plus ICD implantation (ablation group: 68 +/- 8 years; 47 men), whereas 57 were assigned ICD implantation without catheter ablation (ICD-only group: 66 +/- 8 years; 46 men). Primary study end point was the time to first recurrence of ventricular tachycardia/ventricular fibrillation. ICD episodes were assessed and verified by an independent board. Patients were followed up for 2.3 +/- 1.1 years. The primary end point was reached by 25 ablation patients and 26 ICD-only patients. Two-year event-free survival was estimated at 49.0% (95% confidence interval, 33.3%-62.9%) in the former and 52.4% (36.7%-65.9%) in the latter groups. Comparison of episode incidence revealed no significant difference in the primary end point (P=0.84). In an Andersen-Gill regression model with multiple end point recurrences, the difference between the study arms significantly favored catheter ablation for both the primary end point and all but one of the predefined subgroups of detected arrhythmia events. Conclusions-SMS failed to meet the primary end point of time to first ventricular tachycardia/ventricular fibrillation recurrence. However, catheter ablation did reduce the total number of ICD interventions during the duration of follow-up.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Circulation. Arrhythmia and electrophysiology

ISSN

1941-3149

e-ISSN

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Volume of the periodical

10

Issue of the periodical within the volume

3

Country of publishing house

US - UNITED STATES

Number of pages

9

Pages from-to

"art. no. e004422"

UT code for WoS article

000398155700004

EID of the result in the Scopus database

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