Ablative radiosurgery for cardiac arrhythmias - A systematic review

Area of Science:

• Cardiology
• Radiation Oncology
• Medical Physics

Background:

• Stereotactic body radiotherapy (SBRT) is a precise radiation technique typically used for malignant tumors.
• Emerging evidence suggests SBRT's potential efficacy in managing cardiac arrhythmias, including atrial and ventricular types.

Purpose of the Study:

• To systematically review the current literature on the application of SBRT for cardiac arrhythmias.
• To evaluate the existing preclinical, dosimetric, and clinical data regarding SBRT in cardiac arrhythmia treatment.

Main Methods:

• A comprehensive PubMed search was conducted for articles published between 1990 and 2020.
• Included studies comprised original articles, case reports, case series, animal studies, and dosimetric analyses related to cardiac SBRT for arrhythmias.
• A uniform radiation dose of 25Gy was noted across the analyzed studies.

Main Results:

• The search identified 1 phase I/II clinical case series, 3 clinical case reports, 3 animal studies, and 4 dosimetric studies.
• All reviewed studies consistently utilized a 25Gy dose for cardiac SBRT.
• Preclinical, dosimetric, and clinical data indicate SBRT's potential as an alternative treatment for specific arrhythmia cases.

Conclusions:

• Current evidence suggests SBRT is a potential therapeutic option for cardiac arrhythmias.
• Further clinical data and experience are required to establish the safety and efficacy of SBRT for arrhythmias.
• The cardiac and radiation oncology communities anticipate additional research in this novel treatment modality.