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.