Cardiac Stereotactic Body Radiation Therapy (SBRT) for Refractory Ventricular Tachycardia Using Innovative Motion...

Area of Science:

• Cardiology
• Radiation Oncology
• Medical Physics

Background:

• Ventricular tachycardia (VT) is a life-threatening heart rhythm disorder.
• Recurrent VT, especially in patients with structural heart disease, poses significant management challenges.
• Existing treatments like medications, ICDs, and catheter ablation have limitations, with high recurrence rates.

Observation:

• This study details a novel approach for refractory VT using cardiac stereotactic body radiation therapy (SBRT).
• The treatment integrated advanced cardiorespiratory motion tracking (CyberKnife Synchrony) and 3D heart reconstruction (inHeart).
• A 66-year-old male with dilated cardiomyopathy and refractory VT, unresponsive to multiple interventions, was treated.

Findings:

• The patient received a single 25 Gy fraction of SBRT to the arrhythmogenic region, guided by real-time motion tracking.
• Six months post-SBRT, the patient remained free from VT and ICD therapies.
• This case demonstrates successful implementation of cardiac SBRT for refractory VT at the center.

Implications:

• Cardiac SBRT presents a promising, minimally invasive alternative for patients with refractory VT, particularly those with difficult-to-access arrhythmogenic substrates.
• The combination of advanced motion tracking and 3D heart reconstruction enables precise targeting for cardiac SBRT.
• This approach may improve outcomes and reduce the need for repeat interventions in challenging VT cases.