6/27/23, 11:43 PM BERLIN-VT Pathway Feedback Search Clinical Topics Home Studies BERLIN VT BERLIN VT Disease Disease Disease Coronary artery disease Dilated cardiomyopathy Ventric Trial question Is preventive ablation strategy superior to deferred ablation strategy in patients with ischemic cardiomyopathy and implantable defibrillator? Study design Multi-center Open label RCT Population Characteristics of study participants 13.0% female N = 159 87.0% male 159 patients (20 female, 139 male) Inclusion criteria: patients with stable ischemic cardiomyopathy, a LVEF between 30-50%, and VT Key exclusion criteria: age < 18 years or > 80 years; arterial or venous thrombosis; acute myocardial reinfarction; acute coronary syndrome; requirement of chronic renal dialysis Interventions N=76 preventive ablation (prophylactic VT ablation prior to ICD implantation) N=83 deferred ablation (catheter ablation after the third appropriate ICD shock) Primary outcome Composite of death and unplanned hospitalization for symptomatic ventricular arrhythmia or worsening heart failure 32.9 % 32.9 https://web.pathway.md/studies/rec2fFHW3Ko8gj3Zo 1/2 6/27/23, 11:43 PM BERLIN-VT Pathway 27.7 24.7 % 16.4 % 8.2 % No significant difference 0.0 % Preventive ablation Deferred ablation No significant difference in composite of death and unplanned hospitalization for symptomatic ventricular arrhythmia or worsening HF (32.9% vs. 27.7%; HR 1.09, 95% CI 0.62 to 1.92) Secondary outcomes Borderline significant decrease in sustained ventricular tachyarrhythmia (39.7% vs. 48.2%; HR 0.62, 95% CI 0.38 to 1) Significant decrease in appropriate ICD therapy (34.2% vs. 47%; HR 0.55, 95% CI 0.33 to 0.91) Significant decrease in appropriate antitachycardia pacing (34.2% vs. 45.8%; HR 0.57, 95% CI 0.34 to 0.95) Safety outcomes No significant differences in death, unplanned hospitalization. Conclusion In patients with stable ischemic cardiomyopathy, a LVEF between 30-50%, and VT, preventive ablation was not superior to deferred ablation with respect to the composite of death and unplanned hospitalization for symptomatic ventricular arrhythmia or worsening HF. Reference Stephan Willems, Roland Richard Tilz, Daniel Steven et al. Preventive or Deferred Ablation of Ventricular Tachycardia in Patients With Ischemic Cardiomyopathy and Implantable Defibrillator (BERLIN VT): A Multicenter Randomized Trial. Circulation. 2020 Mar 31;141(13):1057-1067. Open reference URL https://web.pathway.md/studies/rec2fFHW3Ko8gj3Zo 2/2