Quality of life with ablation or medical therapy for ventricular arrhythmias: A substudy of VANISH Academic Article uri icon

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  • BACKGROUND/OBJECTIVE: We compared health-related quality of life (HRQoL) in patients randomized to escalated therapy and those randomized to ablation for ventricular tachycardia in the VANISH trial. METHODS: HRQoL was assessed among VANISH patients at baseline and 3-, 6-, and 12-month follow-up visits. Four validated instruments were used: the SF-36, the implanted cardioverter defibrillator (ICD) Concerns questionnaire (ICDC), the Hospital Anxiety and Depression Scale (HADS), and the EuroQol five dimensions questionnaire (EQ-5D). Linear mixed-effects modeling was used for repeated measures with SF-36, HADS, ICDC, and EQ-5D as dependent variables. In a second model, treatment was subdivided by amiodarone use prior to enrollment. RESULTS: HRQoL did not differ significantly between those randomized to ablation or escalated therapy. On subgroup analysis, improvement in SF-36 measures was seen at 6 months in the ablation group for social functioning (63.5-69.3, P = 0.03) and energy/fatigue (43.0-47.9, P = 0.01). ICDC measures showed a reduction in ICD concern in the ablation group at 6 months (10.4-8.7, P = 0.01) and a reduction in ICD concern in the escalated therapy group at 6 months (10.9-9.4, P = 0.04). EQ-5D measures showed a significant improvement in overall health in ablation patients at 6 months (63.4-67.3, P = 0.04). CONCLUSION: Patients in the VANISH study randomized to ablation did not have a significant change in quality of life outcomes compared to those randomized to escalated therapy. Some subgroup findings were significant, as those randomized to ablation showed persistent improvement in SF-36 energy/fatigue and ICD concern, and transient improvement in SF-36 social functioning and EQ-5D overall health.


  • Gula, Lorne J
  • Doucette, Steve
  • Leong-Sit, Peter
  • Tang, Anthony SL
  • Parkash, Ratika
  • Sarrazin, Jean-Francois
  • Thibault, Bernard
  • Essebag, Vidal
  • Tung, Stanley K
  • Deyell, Marc W
  • Raymond, Jean-Marc
  • Lane, Chris
  • Nery, Pablo B
  • Veenhuyzen, George D
  • Redfearn, Damian P
  • Healey, Jeffrey Sean
  • Roux, Jean-Francois
  • Giddens, Karen
  • Sapp, John L

publication date

  • March 2018

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