The Value of Late Non-Invasive Programmed Stimulation (NIPS) in Ventricular Tachycardia Ablation to Guide Subsequent Therapeutic Strategies: A Prospective Randomized Multicenter Study

What this Trial Is About

This research aims to evaluate the role of non-invasive programmed stimulation (NIPS) in predicting the risk of ventricular tachycardia (VT) recurrence after catheter ablation and to identify the best treatment approach. It focuses on whether a new VT ablation guided by NIPS results can better reduce VT recurrence compared to antiarrhythmic drug therapy. The study is a prospective, randomized, multicenter trial involving patients with structural heart disease and implanted defibrillators. Participants will be randomized into two groups: one receiving antiarrhythmic drug therapy (amiodarone, sotalol, or mexiletine) and the other undergoing a repeat VT ablation procedure based on NIPS findings. The ablation involves programmed ventricular stimulation, mapping, VT induction, and catheter ablation targeting VT sources. The drug therapy group will either restart or start antiarrhythmic medications per clinical practice. The study compares these approaches starting 3 to 7 days after an initial successful ablation. During the study, participants will be monitored for VT recurrence over 12 months, with assessments including ICD shocks, VT storms, hospitalizations for VT or heart failure, and cardiac mortality at procedural and follow-up time points. The main outcome measured is the VT recurrence-free survival rate one year after the procedure. Participants will have regular evaluations and follow-ups to track their heart rhythm status and treatment effects throughout the study duration.

Non-Invasive Programmed Stimulation (NIPS) to Guide the Subsequent VT Therapeutic Strategies