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Stereotactic radioablation for ventricular tachycardia

Stereotaktische Radioablation von ventrikulären Tachykardien

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Abstract

Non-invasive stereotactic radioablation of ventricular tachycardia (VT) substrate has been proposed as a novel treatment modality for patients not eligible for catheter-based ablation or in whom this approach has failed. Initial clinical results are promising with good short-term efficacy in VT suppression and tolerable side effects. This article reviews the current clinical evidence for cardiac radioablation and gives an overview of important preclinical and translational results. Practical guidance is provided, and a cardiac radioablation planning and treatment workflow based on expert consensus and the authorsʼ institutional experience is set out.

Zusammenfassung

Die nichtinvasive stereotaktische Radioablation des Substrats ventrikulärer Tachykardien ist ein neuartiges Behandlungsverfahren für Patienten, die entweder für eine Katheterablation nicht infrage kommen oder bei denen interventionelle Ansätze nicht zum Erfolg geführt haben. Erste Ergebnisse klinischer Fallserien zeigen eine gute Wirksamkeit und tolerable unerwünschte Effekte im Kurzzeitverlauf. In dieser Arbeit stellen wir die aktuellen klinischen Daten zur kardialen Radioablation vor und geben eine Übersicht über wichtige Ergebnisse der Grundlagen- und translationalen Forschung in diesem Feld. Abschließend stellen wir basierend auf Expertenkonsensus und unseren Erfahrungen einen Workflow für die Planung und Durchführung der kardialen Bestrahlungstherapie in der Praxis vor.

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Funding

Work by S.H. pertaining to cardiac SABR has been funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—project no. 380200397.

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Authors and Affiliations

  1. Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Stephan Hohmann MD, Henrike A. K. Hillmann MD, Johanna Müller-Leisse MD MSc, Jörg Eiringhaus MD, Christos Zormpas MD, Christian Veltmann MD & David Duncker MD

  2. Department of Radiotherapy, Hannover Medical School, Hannover, Germany

    Roland Merten MD

Authors
  1. Stephan Hohmann MD
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  2. Henrike A. K. Hillmann MD
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  3. Johanna Müller-Leisse MD MSc
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Corresponding author

Correspondence to David Duncker MD.

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Conflict of interest

C. Zormpas received lecture honoraria, travel grants, and/or a fellowship grant from Medtronic and Biotronik. C. Veltmann received lecture and/or consulting honoraria from Abbott, AstraZeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, and Medtronic. D. Duncker received lecture honoraria, travel grants, and/or a fellowship grant from Abbott, AstraZeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Medtronic, Microport, Pfizer, and Zoll. S. Hohmann, H.A. K. Hillmann, J. Müller-Leisse, J. Eiringhaus, and R. Merten declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Hohmann, S., Hillmann, H.A.K., Müller-Leisse, J. et al. Stereotactic radioablation for ventricular tachycardia. Herzschr Elektrophys 33, 49–54 (2022). https://doi.org/10.1007/s00399-021-00830-y

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