Conclusion
This meta-analysis demonstrates that in patients with post-infarct cardiomyopathy and VT, preventive catheter ablation at the time of ICD implantation is associated with a significantly reduced frequency of appropriate ICD therapy and sustained VT/VF, and improvement in the physical component of QOL, but no reduction in mortality. The NNT of 8 to spare one patient from ICD shock(s) should be weighed against a number-needed-to-harm of 21 based on a 4.9% incidence of major ablation-related complications. Further studies should address which subsets of patients will derive maximal net benefit from a preventive ablation strategy at time of secondary prevention ICD implant.