VT questions

I have had an ICD for the past year due to inducible VT. Had mild to moderate CAD, LVEF at 45-55% and am now on 80mg 2x sotalol.

1. What is protocol for having annual echo or cath if there was no evidence originally of MI or damage?

2. Is regular exercise sufficient for keeping LVEF at gold standard?

3. What are the current advances for treating VT with RF or catheter ablation?

Thank you!

[CCF CARDIO MD - DLB]

1. There is no standard protocol. In the absence of symptoms or an abnormal stress test, there would not be any reason to do annual caths. Some cardiologists may do an annual echo in someone like you to monitor LV function, though there really is no data to support this approach, though if you were to have symptoms of heart failure, an echo would certainly be necessary.
2. Regular exercise can help maintain heart function. Medications like ACE inhibitors can also help prevent development of heart failure.
3. Certain forms of VT are very responsive to treatment with ablation, though the most common forms of VT (due to CAD) are usually not. However, in someone with an ICD, ablation can be used to decrease the frequency of VT episodes to prevent the ICD from firing.