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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

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.

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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

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Figure 1
Procedural workflow. CT–computed tomography.
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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.

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