Stereotactic Ablative radiation therapy (SABR) for cardiac arrhythmia: A new therapeutic option?

Fiorentino, Alba; Gregucci, Fabiana; Bonaparte, Ilaria; Vitulano, Nicola; Surgo, A.; Mazzola, Rosario; Monaco, Antonio Di; Carbonara, Roberta; Alongi, Filippo; Langialonga, Tommaso; Grimaldi, Massimo

doi:10.1007/s11547-020-01218-7

Cited by 18 publications

(19 citation statements)

References 30 publications

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“…In terms of TT, Cyberknife device is mounted on a robotic arm to deliver radiation to a tumor from different trajectories, while LINAC with a rotation of its gantry deliver high dose of radiation in a shorter time (3 vs. 90 min) (12). However, the shorter time is essential for reducing intrafraction motion, so in the present trial, due to the motion study and IGRT/SGRT monitoring, the introduction of fiducial was not necessary (3)(4)(5)12).…”

Section: Discussionmentioning

confidence: 93%

“…STAR procedures were shown in Figure 1. They were immobilized using a vac-lock bag and 3 Computed Tomography (CT, 1 mm slice-thickness), in the supine position were performed: basic free-breathing CT for dose calculation; 4-Dimension CT for moving evaluation; CT with contrast for anatomical accuracy (3)(4)(5).…”

Section: Methodsmentioning

confidence: 99%

“…Other ablation approaches have been implemented in cardiac arrhythmia, including stereotactic arrhythmia radioablation (STAR) or radiosurgery which is a safe and effective arm in the oncological and non-oncological scenario. STAR, using high-dose radiation, produced great biological cell kill death by multifactorial results (DNA double-strand breaks, apoptosis, vascular damage, ischemic cell-death) (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Paroxysmal Atrial Fibrillation in Elderly: Worldwide Preliminary Data of LINAC-Based Stereotactic Arrhythmia Radioablation Prospective Phase II Trial

Monaco

Gregucci

Bonaparte

et al. 2022

Front. Cardiovasc. Med.

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Treatment approach for elderly patients with atrial fibrillation (AF) is difficult. The present prospective phase-II trial evaluated LINAC-based stereotactic arrhythmia radioablation safety in this population. The reported data of the first 5 patients worldwide, showed no side effects, absence of AF episodes and without antiarrhythmic drugs.Trial Registration:ClinicalTrials.gov, identifier: NCT04575662.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Paroxysmal Atrial Fibrillation in Elderly: Worldwide Preliminary Data of LINAC-Based Stereotactic Arrhythmia Radioablation Prospective Phase II Trial

Monaco

Gregucci

Bonaparte

et al. 2022

Front. Cardiovasc. Med.

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“…Therefore, noninvasive therapeutic alternatives, including STAR, are warranted. 18 Preclinical and early clinical data suggest that STAR with a single dose of 25Gy could be an efficacy and safe treatment for these patients. Due to the technological improvements in Linac-based stereotactic treatments, including VMAT, IGRT, and FFF, 19,20 the possibility of Linac-based STAR will increase in the course of the next future.…”

Section: Discussionmentioning

confidence: 99%

“…Due to several patients’ issues, catheter‐based ablation approach could not be proposed. Therefore, noninvasive therapeutic alternatives, including STAR, are warranted 18 …”

Section: Discussionmentioning

confidence: 99%

Linac‐based STereotactic Arrhythmia Radioablation (STAR) of ventricular tachycardia: Case report and literature review

Fiorentino

Monaco

Surgo

et al. 2020

Clinical Case Reports

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The state‐of‐the‐art technic of stereotactic radioablation for the treatment of cardiac arrhythmias: An overview

MasoudKabir,

Bayani,

Mousavi Darzikolaee

et al. 2023

Health Science Reports

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IntroductionCardiac arrhythmias, including ventricular tachycardia (VT), stand as a significant threat to health, often leading to mortality and sudden cardiac death. While conventional treatments for VT exhibit efficacy, cases of refractory VT pose challenges. Stereotactic Arrhythmia Radioablation (STAR) offers a novel approach, delivering precise high‐dose radiation to well‐defined targets with minimal collateral damage. This study explores the potential of STAR as an alternative therapy, especially for high‐risk patients or those with refractory VT.MethodsThis research reviews ongoing studies and preliminary investigations into the evaluation of the efficacy and safety of STAR. The method involves targeted radiation delivery, assessing reductions in VT recurrence and the early safety profile in refractory VT patients. However, given STAR's early stage and limited clinical evidence, cautious interpretation is advised.ResultsPreliminary findings indicate a reduction in VT recurrence with STAR, suggesting promise as a therapeutic option. Early safety profiles are encouraging, but definitive statements on efficacy and safety require further investigation. Positive initial outcomes underscore the need for additional data and long‐term studies.ConclusionStereotactic Arrhythmia Radioablation is recently emerging as a promising treatment for refractory VT. While early results are encouraging, careful interpretation is needed, due to STAR's early stages. Ongoing investigations are critical for a comprehensive understanding of its long‐term efficacy and tolerability. This review provides fundamental insights into STAR's background, principles, pre‐treatment procedures, clinical implications, and toxicity, setting the stage for future research in this evolving therapeutic field.

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Stereotactic Ablative radiation therapy (SABR) for cardiac arrhythmia: A new therapeutic option?

Cited by 18 publications

References 30 publications

Paroxysmal Atrial Fibrillation in Elderly: Worldwide Preliminary Data of LINAC-Based Stereotactic Arrhythmia Radioablation Prospective Phase II Trial

Paroxysmal Atrial Fibrillation in Elderly: Worldwide Preliminary Data of LINAC-Based Stereotactic Arrhythmia Radioablation Prospective Phase II Trial

Linac‐based STereotactic Arrhythmia Radioablation (STAR) of ventricular tachycardia: Case report and literature review

The state‐of‐the‐art technic of stereotactic radioablation for the treatment of cardiac arrhythmias: An overview

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