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Stereotactic radiotherapy for ventricular tachycardia: A study protocol.

Mariko Kawamura1, Masafumi Shimojo2, Yasuya Inden2

  • 1Radiology, Nagoya University Hospital, Nagoya, Aichi Prefecture, Japan.

F1000Research
|January 11, 2024
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Summary

Stereotactic radiotherapy offers a new minimally invasive treatment for ventricular tachycardia (VT) and ventricular fibrillation (VF) when catheter ablation fails. This feasibility study assesses its safety and efficacy in refractory VT patients.

Keywords:
RadioablationStereotactic RadioablationStereotactic RadiotherapyVentricular Tachycardia (VT)

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Area of Science:

  • Cardiology
  • Radiation Oncology
  • Medical Physics

Background:

  • Radiofrequency catheter ablation is the standard curative treatment for ventricular tachycardia (VT) and ventricular fibrillation (VF).
  • Deep myocardial VT circuits can be inaccessible to catheter ablation, necessitating novel minimally invasive treatments.
  • Refractory VT/VF poses significant challenges, especially when catheter ablation is unsuccessful.

Purpose of the Study:

  • To evaluate the short-term safety of stereotactic radiotherapy for refractory VT.
  • To assess the efficacy of stereotactic radiotherapy in reducing VT episodes.
  • To provide a potential new treatment option for patients with VT/VF refractory to catheter ablation.

Main Methods:

  • A feasibility study protocol for stereotactic radiotherapy in three patients with refractory VT.
  • Utilizing the CyberKnife M6 radiosurgery system for treatment delivery.
  • Administering a prescribed dose of 25Gy in a single fraction to the target VT substrate.

Main Results:

  • The study is a protocol paper, and results are pending.
  • Primary endpoint: short-term safety of stereotactic radiotherapy.
  • Secondary endpoint: efficacy measured by VT episode reduction.

Conclusions:

  • Stereotactic radiotherapy presents a potential new therapeutic avenue for VT/VF.
  • This study aims to offer hope to patients experiencing ICD activation due to refractory arrhythmias.
  • Further research is needed to establish stereotactic radiotherapy as a viable treatment for intractable VT/VF.