HASKOVA, Jana, Petr PEICHL, Šramko MAREK, Jakub CVEK, Knybel LUKAS, Otakar JIRAVSKÝ, Radek NEUWIRTH and Josef KAUTZNER. Case Report: Repeated Stereotactic Radiotherapy of Recurrent Ventricular Tachycardia: Reasons, Feasibility, and Safety. FRONTIERS IN CARDIOVASCULAR MEDICINE. LAUSANNE: FRONTIERS MEDIA SA, 2022, vol. 9, March 2022, p. 1-9. ISSN 2297-055X. Available from: https://dx.doi.org/10.3389/fcvm.2022.845382.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 3.600
RIV identification code RIV/00216224:14110/22:00126387
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3389/fcvm.2022.845382
UT WoS 000787883100001
Keywords in English Recurrent Ventricular Tachycardia; Repeated Stereotactic Radiotherapy
Tags 14110211, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 1/2/2023 13:41.
Abstract
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.
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