Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Mar 17;10(6):1238.
doi: 10.3390/jcm10061238.

Clinical Evidence behind Stereotactic Radiotherapy for the Treatment of Ventricular Tachycardia (STAR)-A Comprehensive Review

Marcin Miszczyk  1 , Tomasz Jadczyk  2   3 , Krzysztof Gołba  4   5 , Wojciech Wojakowski  2 , Krystian Wita  6 , Jacek Bednarek  7 , Sławomir Blamek  8
Affiliations
Review

Clinical Evidence behind Stereotactic Radiotherapy for the Treatment of Ventricular Tachycardia (STAR)-A Comprehensive Review

Marcin Miszczyk et al. J Clin Med. .

Abstract

The electrophysiology-guided noninvasive cardiac radioablation, also known as STAR (stereotactic arrhythmia radioablation) is an emerging treatment method for persistent ventricular tachycardia. Since its first application in 2012 in Stanford Cancer Institute, and a year later in University Hospital Ostrava, Czech Republic, the authors from all around the world have published case reports and case series, and several prospective trials were established. In this article, we would like to discuss the available clinical evidence, analyze the potentially clinically relevant differences in methodology, and address some of the unique challenges that come with this treatment method.

Keywords: ablation; noninvasive; radiosurgery; stereotactic body radiation therapy; substrate ablation; ventricular tachycardia.

PubMed Disclaimer

Conflict of interest statement

The authors of this manuscript declare authorship and participation in a noncommercial prospective clinical trial SMART-VT (NCT04642963), and European consortium STOSTORM, which has recently obtained a grant from the Horizon2020 framework.

Figures

Figure 1
Figure 1
Procedural workflow. CT–computed tomography.
Figure 2
Figure 2
Literature research workflow.
Figure 3
Figure 3
Pre-treatment cone beam CT (upper-left and lower-right parts) fused with treatment planning CTs. High-density reference points facilitate precise image-guided radiotherapy, despite significant artifacts caused by the Implantable Cardioverter Defibrillator lead.
See this image and copyright information in PMC

References

    1. Tang P.T., Shenasa M., Boyle N.G. Ventricular arrhythmias and sudden cardiac death. Card. Electrophysiol. Clin. 2017;9:693–708. doi: 10.1016/j.ccep.2017.08.004. - DOI - PubMed
    1. Srinivasan N.T., Schilling R.J. Sudden cardiac death and arrhythmias. Arrhythmia Electrophysiol. Rev. 2018;7:111. doi: 10.15420/aer.2018:15:2. - DOI - PMC - PubMed
    1. Shivkumar K. Catheter ablation of ventricular arrhythmias. N. Engl. J. Med. 2019;380:1555–1564. doi: 10.1056/NEJMra1615244. - DOI - PubMed
    1. Al-Khatib S.M., Stevenson W.G., Ackerman M.J., Bryant W.J., Callans D.J., Curtis A.B., Deal B.J., Dickfeld T., Field M.E., Fonarow G.C., 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. Heart Rhythm. 2018;15:e190–e252. - PubMed
    1. Dukkipati S.R., Koruth J.S., Choudry S., Miller M.A., Whang W., Reddy V.Y. Catheter ablation of ventricular tachycardia in structural heart disease: Indications, strategies, and outcomes-Part II. J. Am. Coll. Cardiol. 2017;70:2924–2941. doi: 10.1016/j.jacc.2017.10.030. - DOI - PubMed

LinkOut - more resources