Perspective:

This was a post-approval study of the safety and efficacy of the ablation catheter, and as such, was an observational cohort study, which left much to the discretion of the operator. There was lack of pre-ablation VT data. ICD programming, which can significantly impact whether or not a patient receives a shock, was not standardized. Long-term outcome data were patient reported. Nonetheless, the report is a description of a multicenter experience, which the field does not abound in. There was a significant reduction in shocks, improvement in the quality of life, and less amiodarone use after ablation compared to before ablation. Unfortunately, in this and other similar studies to date, acute procedural success, expressed as noninducibility of VT at the end of the procedure, did not translate into mortality reduction. At this point, we need randomized multicenter data comparing various ablation strategies and their impact on mortality. The next step would be to ascertain the optimal timing of ablation.