Catheter Ablation of VT as the First-Line Therapy in CAD
This study is not a randomized controlled trial, and therefore the inherent limitations of observational studies do apply. In addition, it is a small study with nonhomogeneous study groups. The decision on implantation of an ICD was not random but based on a decision tree. The programming of the ICD after implantation was not unified. It is conceivable that the patient group without an ICD represented a healthier cohort that could have even better survival with an ICD. Additionally, an irrigated tip was not used for all ablation procedures, possibly influencing the result in substrate modification.
The results of this observational study need to be verified in a randomized controlled trial. However, given the low incidence of tolerated VT in patients with CAD and preserved LVEF, the recruitment of patients for such a trial could be challenging.
Limitations
This study is not a randomized controlled trial, and therefore the inherent limitations of observational studies do apply. In addition, it is a small study with nonhomogeneous study groups. The decision on implantation of an ICD was not random but based on a decision tree. The programming of the ICD after implantation was not unified. It is conceivable that the patient group without an ICD represented a healthier cohort that could have even better survival with an ICD. Additionally, an irrigated tip was not used for all ablation procedures, possibly influencing the result in substrate modification.
The results of this observational study need to be verified in a randomized controlled trial. However, given the low incidence of tolerated VT in patients with CAD and preserved LVEF, the recruitment of patients for such a trial could be challenging.
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