Computed tomography-guided vs conventional catheter ablation for ventricular tachycardia: the InEurHeart trial
Frederic Sacher1,2, Tobias Reichlin3, Mathieu Le Bloa4
1Department of Cardiac Pacing and Electrophysiology, Bordeaux University Hospital (CHU), Avenue du Haut Leveque, Bordeaux 33604, France.
European Heart Journal
|February 10, 2026
Summary
Computed tomography (CT)-guided ventricular tachycardia (VT) ablation significantly reduces procedure time compared to conventional methods. This imaging guidance offers a safe and effective alternative for patients with ischaemic cardiomyopathy, improving VT-free survival.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Catheter ablation for recurrent ventricular tachycardia (VT) is complex and center-dependent.
- Pre-procedural imaging guidance shows promise in non-randomized trials for VT ablation.
Purpose of the Study:
- To evaluate computed tomography (CT)-guided VT ablation versus conventional ablation in a multicenter randomized controlled trial.
- To assess if CT guidance reduces procedural duration for VT ablation.
Main Methods:
- A multicenter randomized controlled trial involving 113 patients with prior myocardial infarction and significant VT.
- Patients were assigned to either CT-guided VT ablation (n=57) or conventional VT ablation (n=56).
- Primary endpoint was reduced procedural duration; secondary endpoints included efficacy, safety, and composite outcomes.
Main Results:
- CT-guided VT ablation significantly decreased procedure time by 19% (intention-to-treat) and 28% (per protocol).
- Major adverse events were low and similar between groups (1.8% CT-guided vs. 3.5% conventional).
- One-year VT-free survival was higher in the CT-guided group (76.8% vs. 67.3%), and VT burden decreased by 90%.
Conclusions:
- CT-guided VT ablation is effective in reducing procedure duration for patients with ischaemic cardiomyopathy.
- The technique maintains a favorable safety and efficacy profile compared to conventional VT ablation.
- Image integration using CT provides a valuable advancement for VT ablation procedures.
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