Arrhythmias & electrophysiologyCohort study

Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort

EuropacePublished

  • Prospective cohort study
  • single-group
  • Invasive electroanatomical mapping (Carto3) before stereotactic arrhythmia radioablation (STAR)

Median ablation volume 26 mL (range 14-115); interventricular septum involved in 75%

Authors' conclusion

STAR is a new tool available for the treatment of VT, allowing for a significant reduction of VT burden. VT recurrences are common during follow-up, but no recurrences were observed inside the PTV. Local efficacy was supported by a significant decrease in both bipolar and unipolar signal amplitude.

Study context

Population
Patients with therapy-refractory ventricular tachycardia (VT) (16/20 with ≥1 electrical storm), Swiss cohort, 09.2017–01.2020
Participants
20 patients
Outcome
VT recurrences after STAR and their location relative to the treated volume
Follow-up
Median 25 months

Main finding

As reported in the abstract

VT recurrence and its location relative to the PTV
Developed a recurrence and underwent redo ablation
12/20 (60%)
Recurrence in the proximity of the treated substrate
9
Recurrence remote from the planning target volume (PTV)
3
Recurrence involving a larger substrate over ≥3 LV segments
2
Recurrences inside the PTV
0

Observational data: associations, not effects.

Further findings

VT burden · first 6 months after STAR

VT burden decrease (median, from 108 to 10 VT/semester)
92%

Bipolar and unipolar signal amplitude

Significant decrease in both bipolar and unipolar signal amplitude after STAR

Original publication

Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort. Europace. Published 11 September 2023. doi:10.1093/europace/euad268

Summarised from the published abstract; every number is checked against it