A Study Comparing Catheter Ablation and Non-Invasive Radio-Ablation for Treating Ventricular Tachycardia in Adults 55 and Older

What this Trial Is About

Researchers are evaluating treatments for Ventricular Tachycardia VT, comparing the current standard catheter ablation with a novel non-invasive radio-ablation guided by ECG-based body surface mapping. This trial aims to assess if the non-invasive approach can be a safer and effective alternative for patients, especially those at high risk of complications with traditional treatments. The study is a randomized controlled trial sponsored by the Ottawa Heart Institute Research Corporation, focusing on patients aged 55 and older with cardiomyopathy and recurrent VT despite prior catheter ablation or high-risk features. The trial involves two groups one receiving the standard catheter ablation, which is an invasive procedure using catheters guided by imaging to deliver radiofrequency energy to affected heart tissue, typically lasting around 5 hours under sedation or anesthesia and the other undergoing a non-invasive radio-ablation. The non-invasive procedure uses ECGi mapping under light sedation to identify VT circuits, followed by a brief 15-minute outpatient radiotherapy treatment targeting those areas. Both methods require pre-treatment imaging and medical stabilization, but the non-invasive group avoids catheter insertion. Participants will have multiple assessments including imaging scans like echocardiography, CT, PET, and ECGi mapping. Researchers will monitor outcomes such as time to composite events within 14 days, ICD therapies, VT episodes, hospital admissions, heart failure events, quality of life, and medication use over a period of up to three years. Safety and treatment effects will be carefully tracked, including any procedural complications or inflammation symptoms after radiotherapy. The study provides ongoing follow-up to understand long-term outcomes for both treatments.

Catheter Ablation Versus Radio-Ablation for Ventricular Tachycardia: a Randomized Controlled Trial