A series of case reports on stereotactic body radiation for the treatment of refractory ventricular tachycardia

Abstract

The development of novel treatment methods is crucial for managing refractory ventricular tachycardia resistant to conventional therapies. Stereotactic arrhythmia radiotherapy holds promising potential for such patients, enabling precise non-invasive ablation of arrhythmogenic substrate with minimal damage to surrounding organs. This approach could be invaluable for patients in whom the target tissue is inaccessible through catheter ablation, frequent implantable cardioverter-defibrillator shocks significantly diminish their quality of life, or for those contraindicated for such treatment options due to poor health status. The target for irradiation is precisely defined through prior imaging diagnostics, ECGs of ventricular tachycardias and invasive or non-invasive electrophysiological mapping of the heart. After radiation treatment planning, irradiation of a single high dose of 25 Gy follows, which is generally well tolerated by the patients. Previous studies have reported good treatment efficacy, with a significant reduction in ventricular tachycardia episode frequency, while causing minimal side effects. We report on the first group of four patients with high-risk refractory ventricular tachycardia treated with stereotactic arrhythmia radiotherapy at the Institute of Oncology Ljubljana. This opens new possibilities for the treatment of this vulnerable patient group within the Slovenian healthcare system and contributes to the evolving field of radiotherapeutic treatment.

Keywords

• radiotherapy
• stereotactic radiotherapy
• arrhythmias
• ventricular tachycardia
• cardiac radioablation
• case report