Cardionerds: A Cardiology Podcast 411. Journal Club: The VANISH2 Trial with Dr. Jeff Healey and Dr. Roderick Tung
Feb 24, 2025
Dr. Jeff Healey, a pioneer in ventricular arrhythmias research, and Dr. Roderick Tung, an expert in arrhythmia management, delve into the VANISH2 trial's crucial findings. They discuss the effectiveness of catheter ablation versus antiarrhythmic drugs for patients with ischemic cardiomyopathy. The conversation highlights the trial's impact on treatment choices and patient outcomes, emphasizing the importance of tailored interventions. Additionally, they explore the complexities of managing non-ischemic cardiomyopathy and address safety considerations in arrhythmia therapies.
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Initial Management of Recurrent VT
- In cases of recurrent VT with unchanged coronary anatomy and LV function, start with antiarrhythmic drugs.
- Consider sotalol if the patient has good renal function and moderately impaired ejection fraction.
Effectiveness of Antiarrhythmic Drugs
- Antiarrhythmic drugs like amiodarone and beta-blockers are effective at suppressing VT, as shown in the OPTIC trial.
- There's a bias towards VT ablation at specialized centers, but antiarrhythmics remain the global standard.
Catheter Ablation for Ischemic Cardiomyopathy
- Ischemic cardiomyopathy patients, especially post-infarct, tend to respond better to catheter ablation than non-ischemic ones.
- This is due to more defined scar tissue, making the substrate easier to address.
