EHRA 2026 — Dr Francesco Santoro joins us to discuss findings from his meta-analysis of randomised controlled trials comparing catheter ablation with anti-arrhythmic drug therapy in patients with ventricular tachycardia and ischaemic heart disease.

This meta-analysis pooled data from four RCTs enrolling 947 patients with ischaemic heart disease and ICD implantation, randomised to either catheter ablation or anti-arrhythmic drug therapy. The primary outcome was appropriate ICD therapy, with secondary outcomes including cardiovascular re-hospitalisation, mortality, and adverse events. Subgroup analyses were performed for amiodarone and sotalol separately.

Findings showed that catheter ablation significantly reduced appropriate ICD therapy (31.7% vs. 48.0%), cardiovascular re-hospitalisations, and adverse events compared with drug therapy. Benefits were most pronounced versus sotalol, while no clear advantage over amiodarone was demonstrated.

Interview Questions:

1. What gap in the evidence prompted this meta-analysis?
2. What were the key findings, and which surprised you most?
3. How should clinicians interpret the lack of mortality difference alongside reductions in ICD therapy and re-hospitalisation?
4. What explains the divergence in outcomes between sotalol and amiodarone — and what does this mean for drug selection?
5. Where does catheter ablation now sit in the treatment algorithm for VT in ischaemic cardiomyopathy?
6. What are your key take-home messages for electrophysiologists managing this patient population?

Recorded on-site at EHRA 2026, Vienna.

Editors: Jordan Rance
Videographer: David Ben-Harosh

Support: This is an independent interview produced by Radcliffe Cardiology.