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Review
. 2024 Dec;68(8):893-913.
doi: 10.1111/1754-9485.13662. Epub 2024 May 2.

Radiation therapy for ventricular arrhythmias

Xingzhou Liulu  1 , Poornima Balaji  2   3 , Jeffrey Barber  4   5 , Kasun De Silva  2   3 , Tiarne Murray  4 , Andrew Hickey  4 , Timothy Campbell  2   3 , Jill Harris  4 , Harriet Gee  4   5 , Verity Ahern  4   5 , Saurabh Kumar  2   3   5 , Eric Hau  4   5   6   7 , Pierre C Qian  2   3   5
Affiliations
Review

Radiation therapy for ventricular arrhythmias

Xingzhou Liulu et al. J Med Imaging Radiat Oncol. 2024 Dec.

Abstract

Ventricular arrhythmias (VA) can be life-threatening arrhythmias that result in significant morbidity and mortality. Catheter ablation (CA) is an invasive treatment modality that can be effective in the treatment of VA where medications fail. Recurrence occurs commonly following CA due to an inability to deliver lesions of adequate depth to cauterise the electrical circuits that drive VA or reach areas of scar responsible for VA. Stereotactic body radiotherapy is a non-invasive treatment modality that allows volumetric delivery of energy to treat circuits that cannot be reached by CA. It overcomes the weaknesses of CA and has been successfully utilised in small clinical trials to treat refractory VA. This article summarises the current evidence for this novel treatment modality and the steps that will be required to bring it to the forefront of VA treatment.

Keywords: ablation; non‐invasive; radiosurgery; stereotactic body radiation therapy; ventricular arrhythmias.

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Conflict of interest statement

Verity Ann Ahern is an Editorial Board member of JMIRO and a co‐author of this article. To minimise bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication.

Figures

Fig. 1
Fig. 1
Weaknesses of conventional radiofrequency ablation compared to strengths of stereotactic radiotherapy. (a) Double mechanical valve limiting catheter access into left ventricle. (b) Inability of RF ablation to achieve ablation through scar. (c) Cardiac tamponade as a rare life‐threatening complication from CA. Reprinted [adapted] from Divakara et al.
Fig. 2
Fig. 2
SBRT treatment workflow. Reprinted [adapted] from Qian et al.
Fig. 3
Fig. 3
Future directions for the development of SBRT balancing the risks of adverse effects and efficacy.
See this image and copyright information in PMC

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