The aim of this study is to assess whether preventive substrate ablation of chronic total occlusion infarct-related artery (CTO-IRA) area in heart failure (HF) patients correlates with lower appropriate implantable cardiac defibrillator (ICD) therapies. In addition, the purpose of the study is to determine whether prophylactic substrate ablation at the time of primary ICD implantation in high-risk ischemic patients affects unplanned hospitalization, HF progression, and quality of life.
Who can participate
Age range18 Years – 85 Years
SexALL
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Inclusion criteria
✓. Ischemic cardiomyopathy with reduced ejection fraction (EF ≤ 40%) estimated by cardiac MRI or echocardiography within 30 days before enrollment
✓. Coronary Chronic Total Occlusion (CTO) associated with a previous MI confirmed by coronary angiography and late gadolinium enhancement MRI or myocardial perfusion imaging within 30 days before enrollment
✓. Implantable cardioverter-defibrillator (ICD) indication for primary prevention
✓. Patient has provided written informed consent
Exclusion criteria
✕. Age \< 18 years or \> 85 years
✕. Documented sustained ventricular tachycardia before enrollment
✕. Class IV New York Heart Association (NYHA) heart failure
✕. CTOs not associated with a prior infarction in their territory
✕. Acute myocardial infarction (MI) or acute coronary syndrome
What they're measuring
1
Time to first event comprising appropriate ICD therapy and unplanned hospital admission for symptomatic ventricular tachycardia (VT)/ ventricular fibrillation (VF)
Timeframe: From randomization until official study end or drop-out, patients will be followed and assessed at least 24 months.