# Vroege katheterablatie even effectief als antiaritmica bij ischemische ventriculaire tachycardie — meta-analyse

*geplaatst 2026-08-12 · Atriumfibrilleren · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · doi 10.1093/europace/euag073 · https://hartvaat.nl/2026/06/02/vroege-katheterablatie-even-effectief-als-antiaritmica-bij-ischemische-ventricul/*

Een meta-analyse van drie gerandomiseerde trials (n=618) vergeleek vroege katheterablatie met antiaritmische medicatie als eerste behandeling bij patiënten met een voorgeschiedenis van myocardinfarct en ventriculaire tachycardie. Er waren geen significante verschillen in sterfte, ICD-therapieën of VT-storm tussen beide strategieën, hoewel ablatie gepaard ging met minder ziekenhuisopnames en bijwerkingen, zij het grotendeels gedreven door één trial. Deze bevindingen ondersteunen overweging van ablatie als eerste-linjetherapie bij geselecteerde patiënten, mits rekening wordt gehouden met de heterogeniteit in de onderliggende data.

## English: Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials.

A meta-analysis of three randomized controlled trials (n=618) evaluated early catheter ablation versus antiarrhythmic drugs as initial therapy for ventricular tachycardia in patients with prior myocardial infarction. Both strategies demonstrated comparable efficacy for all-cause mortality, appropriate ICD therapies, and VT storm, while ablation showed a trend toward fewer hospitalizations and adverse events, though largely driven by a single study. These results support considering early ablation as a first-line option in selected patients, pending further confirmation in larger trials.

## Abstract (original, from the publication)

INTRODUCTION: Antiarrhythmic drugs (AADs) have traditionally been used as first-line therapy for ventricular tachycardia (VT) but are frequently associated with systemic toxicities and drug interactions. Therefore, we performed a meta-analysis comparing early catheter ablation (CA) with AAD therapy as initial treatment for VT in patients with prior myocardial infarction. METHODS AND RESULTS: PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials comparing CA vs. AAD in patients naïve to both strategies. Meta-analysis was performed using Review Manager. Three randomized trials including 618 patients were analysed. No significant differences were observed in all-cause mortality, appropriate implantable cardioverter-defibrillator (ICD) therapies (including shocks and antitachycardia pacing), ventricular arrhythmia storm, hospitalizations, or adverse events between strategies. Leave-one-out sensitivity analysis identified one trial as the primary contributor to between-study heterogeneity. CONCLUSION: Early catheter ablation provides similar efficacy to first-line antiarrhythmic drug therapy for major arrhythmic and survival outcomes, with reductions in hospitalizations and treatment-related adverse events, although largely driven by one trial. These findings support consideration of CA as a first-line therapeutic strategy in selected patients with ischaemic VT.

Auteurs: Tiago Moura Façanha, Anna Isabelle Gomes Pereira, Maria Fernanda Carvalho Garcia, Enzo Tunala Mendonça, João Vitor Jacobsen Ramos, Leonardo Antunes Mesquita

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Bron: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, https://doi.org/10.1093/europace/euag073. Bijgewerkt 2026-08-10T10:36:02Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.