4.2 Review

Cardiac stereotactic body radiation therapy for ventricular tachycardia: Current experience and technical gaps

Journal

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Volume 32, Issue 11, Pages 2901-2914

Publisher

WILEY
DOI: 10.1111/jce.15259

Keywords

ablation; cardiac arrhythmias; noninvasive therapy; radiosurgery; radiotherapy; stereotactic body radioablation therapy; ventricular tachycardia

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Cardiac SBRT is a promising emerging therapy for ventricular tachycardia, but technical gaps persist and require ongoing research and clinical experience to address.
Introduction Despite advances in drug and catheter ablation therapy, long-term recurrence rates for ventricular tachycardia remain suboptimal. Cardiac stereotactic body radiotherapy (SBRT) is a novel treatment that has demonstrated reduction of arrhythmia episodes and favorable short-term safety profile in treatment-refractory patients. Nevertheless, the current clinical experience is early and limited. Recent studies have highlighted variable duration of treatment effect and substantial recurrence rates several months postradiation. Contributing to these differential outcomes are disparate approaches groups have taken in planning and delivering radiation, owing to both technical and knowledge gaps limiting optimization and standardization of cardiac SBRT. Methods and Findings In this report, we review the historical basis for cardiac SBRT and existing clinical data. We then elucidate the current technical gaps in cardiac radioablation, incorporating the current clinical experience, and summarize the ongoing and needed efforts to resolve them. Conclusion Cardiac SBRT is an emerging therapy that holds promise for the treatment of ventricular tachycardia. Technical gaps remain, to be addressed by ongoing research and growing clincial experience.

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