Ramsay Newsroom

The landmark CAAD-VT trial (Catheter Ablation versus Anti-arrhythmic Drugs for Ventricular Tachycardia) was presented as a Late Breaking Clinical Trial at the Heart Rhythm Society Annual Scientific Sessions in Chicago recently. 

Led by Associate Professor Saurabh Kumar, a cardiologist and cardiac electrophysiologist at Westmead Private Hospital, the multicentre, randomised clinical trial recruited patients from nine Australian sites and is one of the largest contemporary trials to compare first-line catheter ablation with anti-arrhythmic drug therapy in patients with VT.

Unlike most previous VT studies, which have focused on highly selected or treatment-refractory patients, CAAD-VT enrolled a broad “all-comers” population with structural heart disease, reflecting real-world clinical practice.

The study evaluated clinically significant outcomes including VT recurrence requiring treatment with defibrillator shocks, hospitalisations for heart failure and arrhythmias, need for treatment escalation, and risk of death.

“Over the past two decades, there have been very few randomised studies examining treatment strategies for ventricular tachycardia, particularly in broader patient populations with structural heart disease,” he said.

“CAAD-VT provides important evidence to help guide treatment decisions earlier in the patient journey, rather than waiting until therapies have failed.”

VT is a major complication in patients with cardiomyopathy and other structural heart diseases, often driving repeat hospital admissions and significantly impacting quality of life.

The findings have important implications not only for cardiac electrophysiologists (heart rhythm specialists), but also for general cardiologists managing patients at risk of ventricular arrhythmias.

“This trial demonstrates Australia’s ability to deliver high-quality, practice-changing cardiovascular research through strong national collaboration across leading centres,” Associate Professor Kumar said.

About CAAD-VT
CAAD-VT is a multicentre, open-label, randomised clinical trial comparing catheter ablation with anti-arrhythmic drug therapy as first-line treatment for ventricular tachycardia in patients with structural heart disease. The study recruited 100 patients from nine Australian centres, led by Westmead Hospital along with John Hunter Hospital, Nepean Hospital, The Royal Prince Alfred Hospital, Royal North Shore Hospital, The Alfred Hospital, The Royal Adelaide Hospital, the Prince Charles Hospital, and Gold Coast University Hospital.

The next steps include building on collaborative relationships to investigate with greater scope, the benefits of catheter ablation for patients with VT and structural heart disease attributed to a disease classification called nonischemic cardiomyopathy. This encompasses patients whose hearts have dilated or hypertrophied due to a variety of causes, which in turns leads them to develop VT.