Long Term Follow-Up of Stereotactic Body Radiation Therapy for Refractory Ventricular Tachycardia in Advanced Heart Failure Patients

• DOI: 10.3389/fcvm.2022.849113
• Publication Date: 2022-04-29T05:26:30Z
• Authors: John Wight; Thomas Bigham; Arielle Schwartz; Arslan T. Zahid; Neal Bhatia; Soroosh Kiani; Anand Shah; Stacy Westerman; Kristin Higgins; Michael S. Lloyd
• Keywords: Refractory (planetary science); Cardiac Electrophysiology

Background Initial studies of stereotactic body radiation therapy (SBRT) for refractory ventricular tachycardia (VT) have demonstrated impressive efficacy. Follow-up analyses found mixed results and the role SBRT VT remains unclear. We performed palliative, cardiac radio ablation in patients with to medical management. Methods Arrhythmogenic regions were targeted by combining computed tomography imaging electrophysiologic mapping collaboration from a oncologist, electrophysiologist specialist. Patients treated single fraction 25 Gy. Total durations VT, quantity antitachycardia pacing (ATP) shocks before after treatment as recorded implantable cardioverter-defibrillators (ICDs) analyzed. extended until most recent device interrogation unless transplant, death or repeat occurred sooner. Results Fourteen (age 50–78, four females) had an average two prior ablations. Nine ACC/AHA Stage D heart failure three left assist devices (LVAD). Two died shortly SBRT, one received prompt transplant another significant following months that inaccurately their device. Ten 14 remained adequate data post analysis follow-up duration 216 days. Seven those 10 decrease SBRT. Comparing 90 days cumulative follow-up, 59% reduction 39% ATP 60% shocks. Four Pneumonitis was only complication, occurring fourteen patients. Conclusion may value advanced acutely but utility over long-term appears modest. Prospective randomized is needed better clarify managing VT.