Arrhythmias & electrophysiology
Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review
Authors' conclusion
Among patients with refractory VT in context of structural heart disease, VT burden and ICD shocks are dramatically reduced following cardiac SBRT. The overall mortality in this population with heart failure and refractory VT receiving palliative cardiac SBRT remains high.
Study context
- Population
- Patients with structural heart disease and ventricular tachycardia (VT) refractory to medical therapy and catheter ablation receiving cardiac stereotactic body radiotherapy (SBRT)
- Participants
- 225 patients23 studies
- Comparison
- Post-SBRT vs pre-SBRT
- Outcome
- Rate-ratios of VT episodes, anti-tachycardia pacing (ATP) therapies and implantable cardioverter-defibrillator (ICD) shocks
Methodological detailsrandom-effects, patients as own controls
- Random-effects
- Patients as own controls
Pooled result
As reported in the abstract
VT episodes, ATP therapies, ICD shocks
Post-SBRT vs Pre-SBRTPooled rate-ratio (95% CI)P value
VT episodes
0.10(0.06–0.16)
P < 0.00001ATP therapies
0.09(0.05–0.15)
P < 0.00001ICD shocks
0.09(0.05–0.17)
P < 0.00001Further pooled results
Overall survival post-SBRT · 3, 12 and 24 months
- 3-month survival
- 0.86 (0.80, 0.90)
- 12-month survival
- 0.72 (0.65, 0.78)
- 24-month survival
- 0.57 (0.47, 0.67)
LVEF
- No change in LVEF post-SBRT
- P = 0.3
Safety
Complications
- Pericardial
- 8.0%
- Late oesophagogastro-pericardial fistula
- 0.9%
- Pulmonary
- 5.8%
- Increase in mitral regurgitation reported in some studies
Original publication
Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review. Europace. Published 24 December 2024. doi:10.
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