P1809Noninvasive cardiac radiosurgery: current clinical experience for treatment of refractory arrhythmias

Zei, Paul C.; Gardner, Edward A.; Fogarty, Thomas; Maguire, Patrick

doi:10.1093/ehjci/eux161.118

Cited by 6 publications

(6 citation statements)

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“…The only dosing regimen utilized and evaluated in previous clinical studies involved the delivery of 25 Gy in a single fraction 7,9 . However, the optimal radiation dose is still undetermined.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiation therapy for refractory premature ventricular contractions that originate from the left ventricular summit: A case report

Huang

Gao

et al. 2022

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 99%

Stereotactic body radiation therapy for refractory premature ventricular contractions that originate from the left ventricular summit: A case report

Huang

Gao

et al. 2022

Pacing Clinical Electrophis

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“…To date, more than 50 patients have been treated worldwide, with published data including a total of 43 patients. [41][42][43][44][45][46][47][48][49] The first reported use of SBRT for treatment of VT was published by Loo et al in 2014. It demonstrated a transient decrease in VT episodes for 7 months after a 2-month blanking period after irradiation with 25 Gy.…”

Section: Clinical Application To Treatment Of Ventricular Tachycardiamentioning

confidence: 99%

“…This seminal study was followed by several more case reports detailing the efficacy of cardiac SBRT, with details summarised in Table 1. 42,43,45 The next representative study was a case series conducted by Cuculich et al involving five patients treated for refractory VT, with a resulting 99.9% reduction in VT episodes from baseline, again without complications through a total follow-up period of 46 person-months. 44 The largest study to date, a Phase I/II clinical trial that enrolled 19 with structural heart disease and refractory VT, and observed a 87.6% reduction in total VT burden after a 90-day blanking period.…”

Section: Clinical Application To Treatment Of Ventricular Tachycardiamentioning

confidence: 99%

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Non-invasive Stereotactic Radioablation: A New Option for the Treatment of Ventricular Arrhythmias

Wei

Qian

Tedrow

et al. 2020

Arrhythm Electrophysiol Rev

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Ventricular tachycardia (VT) is associated with significant morbidity and mortality. Radiofrequency catheter ablation can be effective for the treatment of VT but it carries a high rate of recurrence often attributable to insufficient depth of penetration for reaching critical arrhythmogenic substrates. Stereotactic body radioablation (SBRT) is a commonly used technology developed for the non-invasive treatment of solid tumours. Recent evidence suggests that it can also be effective for the treatment of VT. It is a non-invasive procedure and it has the unique advantage of delivering ablative energy to any desired volume within the body to reach sites that are inaccessible with catheter ablation. This article summarises the pre-clinical studies that have formed the evidence base for SBRT in the heart, describes the clinical approaches for SBRT VT ablation and provides perspective on next steps for this new treatment modality.

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“…Early clinical data have demonstrated significant reduction in refractory VT burden with minimal acute and subacute complications. [10][11][12][13][14][15][16][17] While these results show promise, the noninvasive characterization and treatment of substrate brings new technical hurdles which need to be resolved before wider adoption. This review aims to provide an overview of the historical basis for cardiac SBRT, current methods of delivering cardiac radiation, and extant technical challenges, including treatment volume designation and treatment delivery.…”

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confidence: 99%

Cardiac stereotactic body radiation therapy for ventricular tachycardia: Current experience and technical gaps

Wei

Qian

Boeck

et al. 2021

Cardiovasc electrophysiol

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Introduction: Despite advances in drug and catheter ablation therapy, long-term recurrence rates for ventricular tachycardia remain suboptimal. Cardiac stereotactic body radiotherapy (SBRT) is a novel treatment that has demonstrated reduction of arrhythmia episodes and favorable short-term safety profile in treatment-refractory patients. Nevertheless, the current clinical experience is early and limited. Recent studies have highlighted variable duration of treatment effect and substantial recurrence rates several months postradiation. Contributing to these differential outcomes are disparate approaches groups have taken in planning and delivering radiation, owing to both technical and knowledge gaps limiting optimization and standardization of cardiac SBRT. Methods and Findings:In this report, we review the historical basis for cardiac SBRT and existing clinical data. We then elucidate the current technical gaps in cardiac radioablation, incorporating the current clinical experience, and summarize the ongoing and needed efforts to resolve them. Conclusion:Cardiac SBRT is an emerging therapy that holds promise for the treatment of ventricular tachycardia. Technical gaps remain, to be addressed by ongoing research and growing clincial experience.

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P1809Noninvasive cardiac radiosurgery: current clinical experience for treatment of refractory arrhythmias

Cited by 6 publications

References 0 publications

Stereotactic body radiation therapy for refractory premature ventricular contractions that originate from the left ventricular summit: A case report

Stereotactic body radiation therapy for refractory premature ventricular contractions that originate from the left ventricular summit: A case report

Non-invasive Stereotactic Radioablation: A New Option for the Treatment of Ventricular Arrhythmias

Cardiac stereotactic body radiation therapy for ventricular tachycardia: Current experience and technical gaps

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