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For millions living with life-threatening heart arrhythmias, the go-to treatment has long been medication—drugs designed to rein in the heart’s misfires and keep chaos at bay. But a New England Journal of Medicine study by a Dalhousie cardiology researcher demonstrates that a minimally invasive procedure should be considered as the first-line treatment.

The study led by Dr. John Sapp, assistant dean of clinical research at Dalhousie and a cardiologist with Nova Scotia Health, tracked 416 ventricular tachycardia (VT) patients enrolled in 22 health centres for a minimum of two years.

Each patient had an internal defibrillator implanted, a device that shocks the heart back on track when experiencing arrhythmias. The patients were randomly assigned to either drug therapy—amiodarone or sotalol—or catheter ablation, a procedure that allows doctors to discover and cauterize short circuits that cause the heart to misfire.  

The question: which approach reduced VT incidences and posed less risk?

The researchers tracked participants’ erratic heartbeats, electric jolts and emergency visits. A pattern emerged—patients who underwent ablation were 25 per cent less likely to die, experience VT-related shocks, end up in emergency or suffer clusters of arrhythmias called VT storms.

While VT drugs are often effective, Dr. Sapp says they are surpassed by ablation due to their side effects. The leading drug can damage organs over time; the next in line can paradoxically increase the odds of life-threatening arrhythmias. Finding the right dose can be difficult and take time. These risks, impacts, and delays, Dr. Sapp says, make medication a less preferred treatment

Learn more about the study:

DalSolutions: Breakthrough in heart treatment best practice sparks global rethink

Media contact:

Andrew Riley
Senior manager, research and innovation communications
Office of the Vice President, Research and Innovation
E: andrew.riley@dal.ca
P: 902.456.7904