Non-invasive Cardiac Radiation for Ablation of Ventricular Tachycardia: a New Therapeutic Paradigm in Electrophysiology.

Non-invasive ablation of cardiac tissue to control ventricular tachycardia (VT) is a novel therapeutic consideration in the management of ventricular arrhythmias associated with structural heart disease. The technique involves the use of stereotactic radiotherapy delivered to VT substrates. Although invasive mapping can be used to identify the target, the use of non-invasive ECG and imaging techniques combined with multi-electrode body-surface ECG recordings offers the potential of a completely non-invasive approach. Early case series have demonstrated a consistent decrease in VT burden and sufficient early safety to allow more detailed multicenter studies. Such studies are currently in progress to further evaluate this promising technology.

[1]  William J. Bryant,et al.  2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. , 2017, Heart rhythm.

[2]  W. Stevenson,et al.  Noninvasive Ablation of Ventricular Tachycardia. , 2017, The New England journal of medicine.

[3]  D. Hallahan,et al.  Noninvasive Cardiac Radiation for Ablation of Ventricular Tachycardia , 2017, The New England journal of medicine.

[4]  S. Soltys,et al.  Ablative Radiotherapy as a Noninvasive Alternative to Catheter Ablation for Cardiac Arrhythmias , 2017, Current Cardiology Reports.

[5]  A. Moss,et al.  Effects of implantable cardioverter/defibrillator shock and antitachycardia pacing on anxiety and quality of life: A MADIT‐RIT substudy , 2017, American heart journal.

[6]  Robert D Timmerman,et al.  Stereotactic ablative body radiosurgery (SABR) or Stereotactic body radiation therapy (SBRT)☆ , 2017, Advanced drug delivery reviews.

[7]  John L Sapp,et al.  Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs. , 2016, The New England journal of medicine.

[8]  Paul C. Zei,et al.  Stereotactic ablative radiotherapy for the treatment of refractory cardiac ventricular arrhythmia. , 2015, Circulation. Arrhythmia and electrophysiology.

[9]  R. Timmerman,et al.  Emergence of stereotactic body radiation therapy and its impact on current and future clinical practice. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  Y. Rudy,et al.  The electrophysiological cardiac ventricular substrate in patients after myocardial infarction: noninvasive characterization with electrocardiographic imaging. , 2011, Journal of the American College of Cardiology.

[11]  S. Yusuf,et al.  Radiation-Induced Heart Disease: A Clinical Update , 2011, Cardiology research and practice.

[12]  Arjun D. Sharma,et al.  Noninvasive stereotactic radiosurgery (CyberHeart) for creation of ablation lesions in the atrium. , 2010, Heart rhythm.

[13]  Samuel Ryu,et al.  American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the performance of stereotactic body radiation therapy. , 2004, International journal of radiation oncology, biology, physics.

[14]  D. Mark,et al.  Prognostic importance of defibrillator shocks in patients with heart failure. , 2008, The New England journal of medicine.

[15]  Lei Xing,et al.  Stereotactic body radiation therapy in multiple organ sites. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  Judy Powell,et al.  Quality of Life in the Antiarrhythmics Versus Implantable Defibrillators Trial: Impact of Therapy and Influence of Adverse Symptoms and Defibrillator Shocks , 2002, Circulation.

[17]  I. Lax,et al.  Stereotactic radiotherapy of malignancies in the abdomen. Methodological aspects. , 1994, Acta oncologica.

[18]  R. Plonsey,et al.  A Comparison of Volume Conductor and Source Geometry Effects on Body Surface and Epicardial Potentials , 1980, Circulation research.

[19]  L. Leksell The stereotaxic method and radiosurgery of the brain. , 1951, Acta chirurgica Scandinavica.