Arrhythmias & electrophysiologyRandomised controlled trial
Early feasibility study of catheter-free cardiac radioablation with proton beams for refractory ventricular tachycardia
- first-in-human, non-randomized trial
Authors' conclusion
Catheter-free proton CRA for refractory VT was feasible and without definite evidence of associated toxicity, supporting further investigation in larger prospective studies.
Study context
- Population
- Patients with left ventricular ejection fraction (LVEF) <50% and ventricular tachycardia (VT) refractory to antiarrhythmic drugs and prior catheter ablation(s)patients underwent treatment (6 males, mean age 68 years)
- Participants
- 7 patients
Primary result
As reported in the abstract
Rate of VT events · 3 months before treatment vs during follow-up
VT events before treatment
7.24 per patient-month
VT events during follow-up
1.52 per patient-month
event rate reduction
79%
Further findings
LVEF · baseline and last available follow-up
- Median LVEF at baseline
- 26% (IQR 23%-39%)
- Median LVEF at last available follow-up
- 25% (IQR 18%-32%)
Target volume and dose to non-target myocardium
- Median target volume
- 17cm3 (range 8.3-64.9 cm3)
- Median non-target myocardium receiving ≥20 Gy
- 4%
Follow-up
- Median follow-up
- 514 days (range 66-730 days, cumulative 107 patient-months)
Safety
Treatment-related serious adverse events
- No probable or definite treatment-related serious adverse events occurred
Heart transplant and death
- Heart transplant because of end-stage heart failure and VT
- 2 patients, 66 and 514 days after treatment
- Deaths
- 3 patients, at 155 days (end-stage heart failure), 502 days (end-stage heart failure), and 529 days (sudden non-arrhythmic death, likely heart failure-related)
Original publication
Early feasibility study of catheter-free cardiac radioablation with proton beams for refractory ventricular tachycardia. Heart Rhythm. Published 26 April 2026. doi:10.1016/j.hrthm.2026.04.021
Summarised from the published abstract; every number is checked against it