Related Experiment Video

Updated: Jan 9, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

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Catheter Ablation Versus Medical Therapy as First-Line Treatment for Ventricular Electrical Storm: A Systematic

Khalid Sawalha1, Fred Kusumoto2, Mohammad Al-Akchar3

  • 1Department of Cardiovascular Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, USA.

Journal of Cardiovascular Electrophysiology
|December 9, 2025
PubMed

Insights

Catheter ablation (CA) significantly reduces electrical storm (ES) and ventricular arrhythmia recurrence compared to medical therapy alone. This approach also lowers in-hospital mortality and improves survival, supporting its consideration as a first-line treatment for ES.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Interventions

Background:

  • Electrical storm (ES) is a critical condition characterized by recurrent ventricular arrhythmias.
  • Current first-line treatments primarily involve anti-arrhythmic drugs (AADs), but catheter ablation (CA) is emerging as a potential alternative.
  • The comparative efficacy and safety of CA versus escalating medical therapy for ES require further clarification.

Purpose of the Study:

  • To evaluate the effectiveness and safety of radiofrequency catheter ablation (CA) compared to medical therapy (MT) as an initial treatment for electrical storm (ES).
  • To assess the impact of CA on ES recurrence, ventricular arrhythmia (VA) recurrence, in-hospital mortality, and long-term survival.

Main Methods:

  • A systematic literature review and meta-analysis were performed, searching PubMed, Science Direct, and Cochrane databases for relevant studies from 2010 to 2025.
  • Studies comparing first-line CA with escalating MT for ES were included.
  • Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models to analyze outcomes.

Main Results:

  • Six studies involving 963 patients (473 CA, 490 MT) were analyzed.
  • Catheter ablation demonstrated a 71% reduction in ES recurrence compared to medical therapy (OR: 0.29; 95% CI: 0.15-0.53).
  • CA was associated with significantly lower VA recurrence, in-hospital mortality, and improved long-term survival.

Conclusions:

  • Catheter ablation is a superior first-line strategy for managing electrical storm, offering reduced recurrence and mortality.
  • Findings support considering CA as an initial therapy for ES patients.
  • Further large-scale prospective trials are warranted to confirm these results and refine patient selection criteria.
Abstract

Keywords:
catheter ablationelectrical stormoutcomesventricular arrhythmiaventricular tachycardia

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