Leveraging Radiobiology for Arrhythmia Management: A New Treatment Paradigm?

Abstract

Radiation therapy is a well-established approach for safely and non-invasively treating solid tumours and benign diseases with high precision and accuracy. Cardiac radiation therapy has recently emerged as a non-invasive treatment option for the management of refractory ventricular tachycardia. Here we summarise existing clinical and preclinical literature surrounding cardiac radiobiology and discuss how these studies may inform basic and translational research, as well as clinical treatment paradigms in the management of arrhythmias.

Cardiac Arrhythmias in Patients Treated for Lung Cancer: A Review

“…If it is used in antiarrhythmic treatment for VT it is then called stereotactic arrhythmia radioablation (STAR). The underlying mechanism responsible for the rapid reduction in VT frequency and magnitude remains unclear, challenging the previously proposed theory of radiation-induced fibrosis [59,60]. Patient eligibility for this procedure remains controversial [61].…”

Inflammation and fibrosis characterize different stages of myocardial remodeling in patients after stereotactic body radiotherapy of ventricular myocardium for recurrent ventricular tachycardia

“…Most of the patients with known heart disease at risk are implanted prophylactically with ICD. However, ICDs do not prevent occurrence of VTs [2] . Antiarrhytmics are used to treat VT, but their efficacy is limited and in some cases these drugs can be also pro-arrhythmogenic.…”