A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis

• DOI: 10.3389/fcvm.2022.934686
• Publication Date: 2022-08-22T05:58:59Z
• Authors: Mario Levis; Veronica Dusi; Massimo Magnano; Marzia Cerrato; Elena Gallio; Alessandro Depaoli; Federico Ferraris; Gaetano Maria De ...; Umberto Ricardi; Matteo Anselmino
• Keywords: Concomitant; Contractility

Catheter ablation (CA) is the current standard of care for patients suffering drug-refractory monomorphic ventricular tachycardias (MMVTs). Yet, despite significant technological improvements, recurrences remain common, leading to increased morbidity and mortality. Stereotactic arrhythmia radioablation (STAR) increasingly being adopted overcome limitations conventional CA, but its safety efficacy are still under evaluation.We hereby present case a 73-year-old patient implanted with mitral valve prosthesis, cardiac resynchronization therapy-defibrillator, contractility modulation device, who was successfully treated STAR recurrent drug CA-resistant MMVT in setting advanced heart failure giant left atrium. We report 2-year follow-up detailed dosimetric analysis.Our supports early as well long-term 25 Gy single-session STAR. Despite concomitant severe failure, an overall minus planned target volume mean dosage below 5 Gy, no major detrimental side effects were detected. To best our knowledge, analysis most accurate reported so far STAR, particularly what concerns substructures coronary arteries. A shared planning among centers performing will be crucial next future fully disclose profile.