Non-invasive stereotactic body radiation therapy for refractory ventricular arrhythmias: an institutional experience

Chin, Robert; Hayase, Justin; Hu, Peng; Cao, Minsong; Deng, Jie; Ajijola, Olujimi A.; Do, Duc; Vaseghi, Marmar; Buch, Éric; Khakpour, Houman; Fujimura, Osamu; Krokhaleva, Yuliya; Macias, Carlos; Sorg, Julie M.; Gima, Jean; Pavez, Geraldine; Boyle, Noel G.; Steinberg, Michael; Shivkumar, Kalyanam; Bradfield, Jason S.

doi:10.1007/s10840-020-00849-0

Cited by 56 publications

(66 citation statements)

References 18 publications

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“…The study is registered in the ClinicalTrials.gov database of the On the other hand, in the study by Gianni et al [13], despite the favourable safety profile, the efficacy was suboptimal and longterm arrhythmia control was not achieved, similarly to the recently published retrospective case series by Chin et al [11].…”

Section: Trial Registrationmentioning

confidence: 95%

“…Although majority of literature data is in favour of STAR, the inconsistent results of the recent clinical trial [13] and retrospective report [11] warrant further investigation. Considering STAR has never yet been performed in Poland and treatment techniques are significantly different between institutions and authors, a pilot trial focused on treatment safety was chosen to be the most appropriate.…”

Section: Study Rationalementioning

confidence: 95%

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Stereotactic management of arrhythmia – radiosurgery in treatment of ventricular tachycardia (SMART-VT) – clinical trial protocol and study rationale

et al. 2021

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Patients with vetricular tachycardia are usually treated with antiarrhythmic drugs and ablation if the arrhythmia substrate is available for invasive treatment. Despite high efficiency of this treatment there is a significant group of patients who do not benefit from available treatment methods, either because they cannot be applied or do not allow for durable control of the disease. For that reason a novel treatment method, STereotactic Arrhythmia Radioablation (STAR) has been proposed and its safety and efficiency is extensively studied throughout the world. The method is based on irradiation of the arrhythmia substrate identified with electrophysiological examination with high-precision image-guided radiosurgical methods usually used for ablation of malignant tumors. Here we present the protocol of the first Polish study on STAR in patients with intractable ventricular tachycardia (STARVT, NCT04642963), designed to test the safety of the method. Secondary endpoints include measures of the treatment efficiency.

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Section: Trial Registrationmentioning

confidence: 95%

Section: Study Rationalementioning

confidence: 95%

Stereotactic management of arrhythmia – radiosurgery in treatment of ventricular tachycardia (SMART-VT) – clinical trial protocol and study rationale

et al. 2021

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“…Due to the complexity and gravity of these arrhythmias, timely treatment is important. [1][2][3] Ventricular tachycardia (VT) prevalence is directly related to the study population, method of detection, and duration of observation. Treatment approaches for VT are determined according to the underlying heart disease and family history.…”

Section: 2mentioning

confidence: 99%

“…In recent years, SBRT treatment method has also been tried. [1][2][3][4] Catheter ablation procedure in ventricular arrhythmias was developed as inspired by the control of ventricular tachycardia by resection of myocardial scars in surgical studies. The most commonly used energy source in ablation was radiofrequency current.…”

Section: 2mentioning

confidence: 99%

“…It has been emphasised that there was no immediate effect as expected compared to other patient series. 1 The multi-centre and multi-platform RAVENTA (NCT03867747) study is likely to give more clear information about the safety profile (side effect, quality of life, response to treatment, further treatment decision) of cardiac SBRT. Looking at the side effects, seen in the patients treated so far, mild or moderate pneumonia, pericardial effusion, heart failure, nausea, and valvular disease progression were detected.…”

mentioning

confidence: 99%

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Radiofrequency Catheter Ablation Method or Stereotactic Body Radiotherapy in the Treatment of Ventricular Tachycardia

Cihan

2021

J Coll Physicians Surg Pak

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Evaluation of the feasibility of cardiac gating for SBRT of ventricular tachycardia based on real‐time ECG signal acquisition

Reis

Robar

2022

J Applied Clin Med Phys

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Purpose To investigate the feasibility of cardiac synchronized gating in stereotactic body radiation therapy (SBRT) of ventricular tachycardia (VT) using a real‐time electrocardiogram (ECG) signal acquisition. Methods and materials Stability of beam characteristics during simulated ECG gating was examined by developing a microcontroller interface to a Varian Clinac iX linear accelerator allowing gating at frequencies and duty cycles relevant to cardiac rhythm. Delivery accuracy was evaluated by measuring dose linearity with an ionization chamber, and flatness and symmetry with a two‐dimensional detector array, for different gating windows within typical human cardiac cycle periods. To establish a practical method of gating based on actual ECG signals, an AD8232 Heart Monitor board was used to acquire the ECG signal and synchronize the beam delivery. Real‐time cardiac gated delivery measurements were performed for a single 10 × 10 cm 2 field and for a VT‐SBRT plan using intensity‐modulated radiation therapy (IMRT). Results and discussion Dose per monitor unit (MU) values were found to be linear within most gating windows investigated with maximum differences relative to non‐gated delivery of <2% for gating windows ≥200 ms and for >10 MUs. Beam profiles for both gated and non‐gated modes were also found to agree with maximum differences of 0.5% relative to central axis dose for all sets of beam‐on/beam‐off combinations. Comparison of dose distributions for intensity‐modulated SBRT plans between non‐gating and cardiac gating modes provided a gamma passing rate of 97.2% for a 2% 2 mm tolerance. Conclusions Beam output is stable with respect to linearity, flatness, and symmetry for gating windows within cardiac cycle periods. Agreement between dose distributions for VT‐SBRT using IMRT in non‐gated and cardiac cycle gated delivery modes shows that the proposed methodology is feasible. Technically, gating for delivery of SBRT for VT is possible with regard to beam stability.

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Non-invasive stereotactic body radiation therapy for refractory ventricular arrhythmias: an institutional experience

Cited by 56 publications

References 18 publications

Stereotactic management of arrhythmia – radiosurgery in treatment of ventricular tachycardia (SMART-VT) – clinical trial protocol and study rationale

Stereotactic management of arrhythmia – radiosurgery in treatment of ventricular tachycardia (SMART-VT) – clinical trial protocol and study rationale

Radiofrequency Catheter Ablation Method or Stereotactic Body Radiotherapy in the Treatment of Ventricular Tachycardia

Evaluation of the feasibility of cardiac gating for SBRT of ventricular tachycardia based on real‐time ECG signal acquisition

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