Trial Comparing Ablation With Medical Therapy in Patients With Ventricular Tachycardia

Inclusion Criteria: * Sustained monomorphic VT (\>30 seconds, or requiring appropriate ICD therapy in patients with ICDs) * Documented ischemic heart disease with no further options for revascularization * Ability and willingness to give written informed consent to participate in the trial Exclusion Criteria: * VT in the setting of metabolic abnormalities or acute ischemia if coronary lesions suitable for revascularization are identified. * Acute ischemia with eligibility for revascularization * Significant peripheral arterial disease preventing transvascular access to the left ventricle. * Patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), hypertrophic cardiomyopathy, Brugada syndrome, Long QT syndromes, dilated cardiomyopathy * Prior long term therapy with a Class III or Class IC antiarrhythmic agent (longer than 2 weeks) * Patient is or may be potentially pregnant * Patient has a mechanical heart valve * Myocardial infarction within the past 90 days * Stroke within the past 90 days * New York Heart Association (NYHA) functional class IV * Hemorrhagic manifestations, bleeding diathesis, or impairment of hemostasis * Lesions at risk of clinically significant bleeding (e.g., extensive cerebral infarction within the last 6 months, active peptic ulcer disease with recent bleeding) * Prior VT ablation procedure * Contraindication or allergy to contrast media, routine procedural medications or catheter materials * Contraindications to an interventional procedure * Life expectancy is less than 6 months * Incessant or multiple episodes of VT requiring immediate therapy with medications or ablation * Untreated hypothyroidism or hyperthyroidism (euthyroid or thyroid hrt is acceptable) * Current enrolment in another investigational drug or device study * There are other conditions present that the investigator feels would be problematic or would restrict or limit the participation for the patient for the entire study period * Absolute contraindication to the use of heparin or warfarin * Documented intra-arterial thrombus, ventricular thrombus, (less than 6 months after detection of thrombus), tumor or other abnormality that precludes catheter introduction