Arrhythmias & electrophysiologyMeta-analysis
Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review
- Systematic review and meta-analysis
- random-effects
- patients as own controls
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 patients · 23 studies
- Comparison
- Post-SBRT vs pre-SBRT
- Outcome
- Rate-ratios of VT episodes, ATP therapies and ICD shocks
Pooled result
As reported in the abstract
VT episodes, ATP therapies, ICD shocks
- VT episodes
- pooled rate-ratio 0.10 (95% CI 0.06–0.16); P < 0.00001
- Anti-tachycardia pacing (ATP) therapies
- pooled rate-ratio 0.09 (95% CI 0.05–0.15); P < 0.00001
- Implantable cardioverter-defibrillator (ICD) shocks
- pooled rate-ratio 0.09 (95% CI 0.05–0.17); P < 0.00001
Further 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:10.1093/europace/euae305
Summarised from the published abstract; every number is checked against it