Stereotactic body radioablation therapy as an immediate and early term antiarrhythmic palliative therapeutic choice in patients with refractory ventricular tachycardia
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info:eu-repo/semantics/openAccessTarih
2023Yazar
Aras, DursunÇetin, Elif Hande Özcan
Öztürk, Hüseyin Furkan
Özdemir, Elif
Kara, Meryem
Ekizler, Firdevs Ayşenur
Özeke, Özcan
Özcan, Fırat
Korkmaz, Ahmet
Kervan, Ümit
Turhan, Nesrin
Coşkun, Nazım
Topaloğlu, Serkan
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Aras, D., Çetin, E. H. Ö., Öztürk, H. F., Özdemir, E., Kara, M., Ekizler, F. A. ... Topaloğlu, S. (2023). Stereotactic body radioablation therapy as an immediate and early term antiarrhythmic palliative therapeutic choice in patients with refractory ventricular tachycardia. Journal of Interventional Cardiac Electrophysiology, 66(1), 135-143. https://doi.org/10.1007/s10840-022-01352-4Özet
Background: Stereotactic body radioablation therapy (SBRT) has recently been introduced with the ability to provide ablative energy noninvasively to arrhythmogenic substrate while reducing damage to normal cardiac tissue nearby and minimizing patients’ procedural risk. There is still debate regarding whether SBRT has a predominant effect in the early or late period after the procedure. We sought to assess the time course of SBRT’s efficacy as well as the value of using a blanking period following a SBRT session. Methods: Eight patients (mean age 58 ± 14 years) underwent eight SBRT sessions for refractory ventricular tachycardia (VT). SBRT was given using a linear accelerator device with a total dose of 25 Gy to the targeted area. Results: During a median follow-up of 8 months, all patients demonstrated VT recurrences; however, implantable cardioverter-defibrillator (ICD) and anti-tachycardia pacing therapies were significantly reduced with SBRT (8.46 to 0.83/per month, p = 0.047; 18.50 to 3.29/per month, p = 0.036, respectively). While analyzing the temporal SBRT outcomes, the 2 weeks to 3 months period demonstrated the most favorable outcomes. After 6 months, one patient was ICD therapy-free and the remaining patients demonstrated VT episodes. Conclusions: Our findings showed that the SBRT was associated with a marked reduction in the burden of VT and ICD interventions especially during first 3 months. Although SBRT does not seem to succeed complete termination of VT in long-term period, our findings support the strategy that SBRT can be utilized for immediate antiarrhythmic palliation in critically ill patients with otherwise untreatable refractory VT and electrical storm.
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Journal of Interventional Cardiac ElectrophysiologyCilt
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