The Lead Episode 36: One-Year Outcomes Following Stereotactic Body Radiotherapy for Refractory Ventricular Tachycardia-The Lead Episode 36 Visual Aid

The Lead Episode 36 Visual Aid

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Researchers conducted a study to evaluate the safety and effectiveness of stereotactic body radiotherapy (SBRT) for refractory ventricular tachycardia (VT). The study involved 15 patients who had failed traditional therapy, including antiarrhythmic drugs and catheter ablation. The patients underwent SBRT treatment with a single 25 gray fraction. Clinical outcomes were analyzed at 6 weeks, 6 months, and 12 months after treatment. The main outcome measures were VT burden (ICD shocks and ATP sequences) and clinical and safety outcomes.<br /><br />The results showed that 14 out of the 15 patients underwent treatment, with 12 surviving to the end of the 6-week period and 10 surviving to 12 months. There was a significant reduction in treated VT episodes at 6 weeks to 6 months and 6 to 12 months compared to the 6 months prior to treatment. Recurrence of VT occurred in 33% of patients from 6 weeks to 12 months, resulting in appropriate ATP or ICD shocks. There were no significant changes in ventricular function or safety outcomes, such as radiation pneumonitis or pericardial effusion. Four deaths occurred after treatment, with two possibly related to SBRT.<br /><br />The study concluded that SBRT is associated with a reduction in treated VT episodes and appropriate ICD therapies over 1 year in select high-risk patients with refractory VT. The close collaboration between electrophysiology and radiation oncology teams was crucial for targeting. The study suggests the need for further randomized controlled trials to refine the dosing and role of SBRT in the treatment of VT. However, limitations of the study include its small sample size and the heterogeneity of the patient population.<br /><br />In summary, SBRT shows promise as a noninvasive treatment option for refractory VT. Further research is needed to fully understand its mechanisms of action and optimize its use in clinical practice.

Keywords

stereotactic body radiotherapy

refractory ventricular tachycardia

clinical outcomes

VT burden

safety outcomes

treated VT episodes

recurrence of VT

radiation pneumonitis

pericardial effusion

noninvasive treatment option