Arrhythmias & electrophysiology
Stereotactic arrhythmia radioablation in patients with refractory ventricular tachycardia: a systematic review and meta-analysis
Authors' conclusion
STAR significantly reduces VT episodes and ICD shocks, offering symptomatic relief. However, high recurrence rates and severe AEs underscore the need for protocol optimisation and multidisciplinary collaboration to improve STAR’s safety and efficacy in VT management.
Study context
- Population
- Patients with therapy-refractory monomorphic ventricular tachycardia treated with stereotactic arrhythmia radioablation (STAR)
- Participants
- 215 patients22 studies
- Outcome
- Overall survival
- Follow-up
- Mean 11.9±6.6 months
Methodological detailsrandom-effects models with double arcsine transformation, prospective and retrospective studies only
- Random-effects models with double arcsine transformation
- Prospective and retrospective studies only
Pooled result
As reported in the abstract
Overall survival
69.6%
95% CI 62.6% to 76.2%
Further pooled results
Reduction in ventricular tachycardia (VT) episodes and implantable cardioverter-defibrillator (ICD) shocks/month
- VT episodes reduced by
- 81.5% (95% CI 64.2% to 94.8%)
- ICD shocks/month reduced by
- 84.7% (95% CI 65.1% to 98.1%)
Freedom from VT · end of follow-up
- VT-free
- 23.1% (95% CI 10.7% to 37.7%)
Subgroup analyses by study design and planning target volume (PTV)
- No significant differences in clinical outcomes between prospective and retrospective studies, nor between studies with high PTV and low PTV
Safety
Adverse events
- Adverse events (AEs) reported
- 352
- Patients with AEs reported
- 280
- Mean AE per patient
- 1.26
- AEs classified as severe
- 50.6%
- AEs likely STAR-related
- 9.7%
- AEs were qualitatively analysed and classified by organ system, severity and causality
Original publication
Stereotactic arrhythmia radioablation in patients with refractory ventricular tachycardia: a systematic review and meta-analysis. Heart. Published 9 July 2025. doi:10.
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