At 2 years, any VT had recurred in 53% of the ablation group and 71% of the control group. Ablation prolonged the time to recurrent VT from a median of 5.9 Several non- randomized studies have shown that catheter ablation reduces the risk of recurrent VT or ICD shocks in patients with sustained VT related to In a multicenter study of catheter ablationS7.1.3-7 for patients with 3 episodes of sustained VT in the prior 6 months, 53% were free from recurrent VT at 6 months fol- low-up; the median number of VT episodes was reduced from 11.5 to 0. A meta-analysis of 5 VT reported that VT recurred in 35% of patients after catheter ablation com- pared with 55% on antiarrhythmic medications. Another study of 63 patients with recurrent VT after MI demonstrated acute success with cath- eter ablation in 83% of mappable VTs and 40% of nonmappable VTs.S7.1.3-8 Superiority of ablation over escalating medication therapy for patients with recurrent VT despite antiarrhythmic medica- tions was shown by the VANISH trial.S7.1.3-4 See Section 5.6. demonstrated higher rates of mortal- ity or nonfatal cardiac arrest in post-MI patients treated with encainide or flecainide when used to suppress PVCs and NSVT.S7.1.3-13 Propafenone is associated with increased mortality in SCA survi- vors compared with beta blockers, amiodarone, and the ICD.S7.1.3-22 5. Implantation of an ICD prior to achieving sup- pression of frequent or incessant VA places the patient at high risk of repetitive shocks, which can be psychologically detrimental and has been asso- ciated with increased mortality.S7.1.3-23,S7.1.3-24 6. Sustained monomorphic VT in the setting of prior MI is typically due to scar-related reentry and is not due to acute ischemia. 