J 2022

Case Report: Repeated Stereotactic Radiotherapy of Recurrent Ventricular Tachycardia: Reasons, Feasibility, and Safety

HASKOVA, Jana, Petr PEICHL, Šramko MAREK, Jakub CVEK, Knybel LUKAS et. al.

Basic information

Original name

Case Report: Repeated Stereotactic Radiotherapy of Recurrent Ventricular Tachycardia: Reasons, Feasibility, and Safety

Authors

HASKOVA, Jana (203 Czech Republic, guarantor), Petr PEICHL (203 Czech Republic), Šramko MAREK (203 Czech Republic), Jakub CVEK (203 Czech Republic), Knybel LUKAS (203 Czech Republic), Otakar JIRAVSKÝ (203 Czech Republic), Radek NEUWIRTH (203 Czech Republic, belonging to the institution) and Josef KAUTZNER (203 Czech Republic)

Edition

FRONTIERS IN CARDIOVASCULAR MEDICINE, LAUSANNE, FRONTIERS MEDIA SA, 2022, 2297-055X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.600

RIV identification code

RIV/00216224:14110/22:00126387

Organization unit

Faculty of Medicine

DOI

UT WoS

000787883100001

Keywords in English

Recurrent Ventricular Tachycardia; Repeated Stereotactic Radiotherapy

Tags

Tags

International impact, Reviewed
Změněno: 1/2/2023 13:41, Mgr. Tereza Miškechová

Abstract

V originále

Stereotactic body radiotherapy (SBRT) has been reported as an attractive option for cases of failed catheter ablation of ventricular tachycardia (VT) in structural heart disease. However, even this strategy can fail for various reasons. For the first time, this case series describes three re-do cases of SBRT which were indicated for three different reasons. The purpose in the first case was the inaccuracy of the determination of the treatment volume by indirect comparison of the electroanatomical map and CT scan. A newly developed strategy of co-registration of both images allowed precise targeting of the substrate. In this case, the second treatment volume overlapped by 60% with the first one. The second reason for the re-do of SBRT was an unusual character of the substrate-large cardiac fibroma associated with different morphologies of VT from two locations around the tumor. The planned treatment volumes did not overlap. The third reason for repeated SBRT was the large intramural substrate in the setting of advanced heart failure. The first treatment volume targeted arrhythmias originating in the basal inferoseptal region, while the second SBRT was focused on adjacent basal septum without significant overlapping. Our observations suggested that SBRT for VT could be safely repeated in case of later arrhythmia recurrences (i.e., after at least 6 weeks). No acute toxicity was observed and in two cases, no side effects were observed during 32 and 22 months, respectively. To avoid re-do SBRT due to inaccurate targeting, the precise and reproducible strategy of substrate identification and co-registration with CT image should be used.