 This will be a multicentre, parallel group, two arm, unblinded vanguard pilot randomized clinical trial. A vanguard pilot study design is chosen in order to prove feasibility without committing to the full trial until feasibility is demonstrated. Implantable Defibrillators ICDs reduce sudden death and can terminate some VT without shocks, but they dont prevent VT; the most appropriate strategy to suppress VT remains unknown. The widespread use of ICDs means patients who formerly would have suffered sudden death now survive, and may experience recurrent VT and ICD therapy. Therapeutic options for VT are limited. Appropriate ICD programming reduces unnecessary shocks, but VT may still recur and require therapy. VANISH 2 will assess the outcomes of patients with prior MI and VT randomized to catheter ablation or antiarrhythmic drug therapy. 