Arrhythmias & electrophysiology

Stereotactic Arrhythmia Radioablation of Recurrent Ventricular Tachycardia in Structural Heart Disease: Results of the Aborted STAR-VT-2020 Randomized Trial

JACC Clin ElectrophysiolPublished randomized trial

Primary result · VT recurrenceResult — go to the resultHazard ratio 2.5 95% CI 0.97–6.6
  • prematurely terminated

Authors' conclusion

The STAR-VT-2020 trial suggests a potential clinical benefit of repeated CA over STAR in patients with SHD, despite prior failed CA at specialized centers. Because of the small study cohort of highly selected patients and several methodological limitations, the results of the prematurely terminated trial should be considered exploratory and interpreted strictly as hypothesis generating. Larger trials with optimized design are warranted. (Stereotactic Ablative Radiosurgery of Recurrent Ventricular Tachycardia in Structural Heart Disease; NCT04612140).

Study context

Population
Patients with structural heart disease and recurrent ventricular tachycardia after a failure of previous catheter ablation11 in each group, followed for 28 ± 17 months
Participants
22 patients
Comparison
Stereotactic arrhythmia radioablation (STAR) vs catheter ablation (CA) after a failure of previous CA
  • STARn = 11
  • CAn = 11reference
Primary endpoint
Ventricular tachycardia (VT) recurrence
Follow-up
28 ± 17 months
Methodological details2 centers, 1:1, covariate-adaptive algorithm
  • 2 centers
  • 1:1
  • Covariate-adaptive algorithm

Primary result

As reported in the abstract

Hazard ratio

2.5

95% CI 0.97–6.6

STARvs CA
HR 2.5 (95% CI 0.97–6.6)

Secondary outcomes

OutcomeHR (95% CI)
Repeated CA for VT (secondary endpoint)Significantly higher risk with STAR4.0 (1.2–13.8)

Trial conduct

Trial prematurely terminated

Safety

Death, heart transplantation, left ventricular assist device · Throughout the trial

Patients died
13
Underwent heart transplantation
3
Received left ventricular assist devices
3
No significant differences between the 2 groups

Original publication

Stereotactic Arrhythmia Radioablation of Recurrent Ventricular Tachycardia in Structural Heart Disease: Results of the Aborted STAR-VT-2020 Randomized Trial. JACC Clin Electrophysiol. Published 31 July 2026. doi:10.1016/j.jacep.2026.06.043

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