Quality of life with ablation or medical therapy for ventricular arrhythmias: A substudy of VANISH

Quality of life with ablation or medical therapy for ventricular arrhythmias: A substudy of VANISH 1INTRODUCTIONPatients with ischemic cardiomyopathy are at risk of scar‐related ventricular arrhythmias. Implanted cardioverter defibrillators (ICDs) reduce mortality by delivering pacing or shock therapies, but these therapies to reduce ventricular arrhythmias may reduce quality of life. The VANISH trial compared strategies of escalated antiarrhythmic drug (AAD) therapy with catheter ablation in patients with ischemic cardiomyopathy and ventricular tachycardia (VT) despite first‐line AAD therapy. It demonstrated a reduction in the composite outcome of death, VT, or appropriate ICD shock in the ablation group. We aimed to compare health‐related quality of life (HRQoL) in patients randomized to escalated therapy and those randomized to ablation in the VANISH trial. We hypothesized that ablation would improve HRQoL by reducing anxiety related to anticipation of arrhythmia symptoms or recurrent ICD shocks.2METHODS2.1VANISH trialThe methods, inclusion and exclusion criteria of the VANISH trial, have been previously published. Briefly, VANISH was a multicenter, randomized trial at 22 ablation centers in Canada, Europe, the United States, and Australia. Eligible patients had a history of myocardial infarction, ICD implant, and recent monomorphic VT treated with amiodarone or a class I or III AAD. Patients were randomized to catheter ablation for VT, or an escalation in AAD therapy. In the escalated http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Cardiovascular Electrophysiology Wiley