Arrhythmias & electrophysiology
Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort
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
Methodological detailssingle-group, Invasive electroanatomical mapping (Carto3) before stereotactic arrhythmia radioablation (STAR), Median ablation volume 26 mL (range 14-115); interventricular septum involved in 75%
- Single-group
- Invasive electroanatomical mapping (Carto3) before STAR
- Median ablation volume 26 mL (range 14-115); interventricular septum involved in 75%
Main finding
As reported in the abstract
- 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.
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