Ablative radiosurgery for cardiac arrhythmias - A systematic review

Stereotactic body radiotherapy (SBRT) is a high precision technique that is commonly used for malignant lesions in lung, liver, pancreas and spine. Recent reports suggest promise in use of SBRT as a tool in atrial and ventricular cardiac arrhythmias. The present systematic review deals with the use of SBRT technology for this novel indication. A PubMed search was done for articles published between 1990 and 2020. All original articles, case reports, case series of treated patients were included in the analyses. Out of the 55 articles in PubMed search, our search found 1 phase I/II clinical case series, 3 clinical case reports, 3 animal studies and 4 dosimetric studies related to cardiac SBRT for arrythmias. All studies used a uniform cardiac dose of 25Gy. The available preclinical, dosimetric and clinical studies have suggested that SBRT for cardiac arrhythmias could become a potential alternative in suitable patients. Cardiac and radiation oncology community await further data and experience in this modality, including safety and outcomes.