Efficacy and Safety of Stereotactic Radiotherapy in Patients
With Recurrent Ventricular Tachycardias

J 2024

Efficacy and Safety of Stereotactic Radiotherapy in Patients With Recurrent Ventricular Tachycardias

HASKOVA, Jana; Dan WICHTERLE; Josef KAUTZNER; Marek SRAMKO; Petr PEICHL et al.

Základní údaje

Originální název

Efficacy and Safety of Stereotactic Radiotherapy in Patients With Recurrent Ventricular Tachycardias

Autoři

HASKOVA, Jana; Dan WICHTERLE; Josef KAUTZNER; Marek SRAMKO; Petr PEICHL; Lukas KNYBEL; Otakar JIRAVSKÝ; Radek NEUWIRTH a Jakub CVEK

Vydání

JACC: Clinical Electrophysiology, Amsterdam, Elsevier, 2024, 2405-500X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 7.700

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/24:00137797

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

catheter ablation; complications; stereotactic arrhythmia radiotherapy (STAR); ventricular tachycardia

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 28. 11. 2024 08:37, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND Stereotactic arrhythmia radiotherapy (STAR) has been proposed recently in patients with refractory ventricular tachycardia (VT). OBJECTIVES The purpose of this study was to describe the efficacy and safety of STAR in the Czech Republic. METHODS VT patients were recruited in 2 expert centers after at least 1 previously failed catheter ablation (CA). A precise strategy of target volume determination and CA was used in 17 patients treated from December 2018 until June 2022 (EFFICACY cohort). This group, together with an earlier series of 19 patients with less-defined treatment strategies, composed the SAFETY cohort (n = 36). A dose of 25 Gy was delivered. RESULTS In the EFFICACY cohort, the burden of implantable cardioverter-defibrillator therapies decreased, and this drop reached significance for direct current shocks (1.9 +/- 3.2 vs 0.1 +/- 0.2 per month; P = 0.03). Eight patients (47%) underwent repeated CA for recurrences of VT during 13.7 +/- 11.6 months. In the SAFETY cohort (32 procedures, follow-up >6 months), 8 patients (25%) presented with a progression of mitral valve regurgitation, and 3 (9%) required intervention (median follow-up of 33.5 months). Two cases of esophagitis (6%) were seen with 1 death caused by the esophago-pericardial fistula (3%). A total of 18 patients (50%) died during the median follow-up of 26.9 months. CONCLUSIONS Although STAR may not be very effective in preventing VT recurrences after failed CA in an expert center, it can still modify the arrhythmogenic substrate, and when used with additional CA, reduce the number of implantable cardioverter-defibrillator shocks. Potentially serious sides effects require close follow-up.

Návaznosti

LX22NPO5104, projekt VaV

Název: Národní institut pro výzkum metabolických a kardiovaskulárních onemocnění (Akronym: CarDia)

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Národní institut pro léčbu metabolických a kardiovaskulárních onemocnění, 5.1 EXCELES

Přiložené soubory

Efficacy_and_Safety_of_Stereotactic_Radiotherapy_in_Patients_With_Recurrent_Ventricular_Tachycardias_The_Czech_Experience.pdf

Citovat

HASKOVA, Jana; Dan WICHTERLE; Josef KAUTZNER; Marek SRAMKO; Petr PEICHL; Lukas KNYBEL; Otakar JIRAVSKÝ; Radek NEUWIRTH a Jakub CVEK. Efficacy and Safety of Stereotactic Radiotherapy in Patients With Recurrent Ventricular Tachycardias. JACC: Clinical Electrophysiology. Amsterdam: Elsevier, 2024, roč. 10, č. 4, s. 654-666. ISSN 2405-500X. Dostupné z: https://doi.org/10.1016/j.jacep.2023.12.002.

@article{2455437,
   author = {Haskova, Jana and Wichterle, Dan and Kautzner, Josef and Sramko, Marek and Peichl, Petr and Knybel, Lukas and Jiravský, Otakar and Neuwirth, Radek and Cvek, Jakub},
   article_location = {Amsterdam},
   article_number = {4},
   doi = {https://doi.org/10.1016/j.jacep.2023.12.002},
   keywords = {catheter ablation; complications; stereotactic arrhythmia radiotherapy (STAR); ventricular tachycardia},
   language = {eng},
   issn = {2405-500X},
   journal = {JACC: Clinical Electrophysiology},
   title = {Efficacy and Safety of Stereotactic Radiotherapy in Patients With Recurrent Ventricular Tachycardias},
   url = {https://www.sciencedirect.com/science/article/pii/S2405500X23009076?via%3Dihub},
   volume = {10},
   year = {2024}
}

TY  - JOUR
ID  - 2455437
AU  - Haskova, Jana - Wichterle, Dan - Kautzner, Josef - Sramko, Marek - Peichl, Petr - Knybel, Lukas - Jiravský, Otakar - Neuwirth, Radek - Cvek, Jakub
PY  - 2024
TI  - Efficacy and Safety of Stereotactic Radiotherapy in Patients With Recurrent Ventricular Tachycardias
JF  - JACC: Clinical Electrophysiology
VL  - 10
IS  - 4
SP  - 654-666
EP  - 654-666
PB  - Elsevier
SN  - 2405500X
KW  - catheter ablation
KW  - complications
KW  - stereotactic arrhythmia radiotherapy (STAR)
KW  - ventricular tachycardia
UR  - https://www.sciencedirect.com/science/article/pii/S2405500X23009076?via%3Dihub
N2  - BACKGROUND Stereotactic arrhythmia radiotherapy (STAR) has been proposed recently in patients with refractory ventricular tachycardia (VT). OBJECTIVES The purpose of this study was to describe the efficacy and safety of STAR in the Czech Republic. METHODS VT patients were recruited in 2 expert centers after at least 1 previously failed catheter ablation (CA). A precise strategy of target volume determination and CA was used in 17 patients treated from December 2018 until June 2022 (EFFICACY cohort). This group, together with an earlier series of 19 patients with less-defined treatment strategies, composed the SAFETY cohort (n = 36). A dose of 25 Gy was delivered. RESULTS In the EFFICACY cohort, the burden of implantable cardioverter-defibrillator therapies decreased, and this drop reached significance for direct current shocks (1.9 +/- 3.2 vs 0.1 +/- 0.2 per month; P = 0.03). Eight patients (47%) underwent repeated CA for recurrences of VT during 13.7 +/- 11.6 months. In the SAFETY cohort (32 procedures, follow-up >6 months), 8 patients (25%) presented with a progression of mitral valve regurgitation, and 3 (9%) required intervention (median follow-up of 33.5 months). Two cases of esophagitis (6%) were seen with 1 death caused by the esophago-pericardial fistula (3%). A total of 18 patients (50%) died during the median follow-up of 26.9 months. CONCLUSIONS Although STAR may not be very effective in preventing VT recurrences after failed CA in an expert center, it can still modify the arrhythmogenic substrate, and when used with additional CA, reduce the number of implantable cardioverter-defibrillator shocks. Potentially serious sides effects require close follow-up.
ER  -

HASKOVA, Jana; Dan WICHTERLE; Josef KAUTZNER; Marek SRAMKO; Petr PEICHL; Lukas KNYBEL; Otakar JIRAVSKÝ; Radek NEUWIRTH a Jakub CVEK. Efficacy and Safety of Stereotactic Radiotherapy in Patients With Recurrent Ventricular Tachycardias. \textit{JACC: Clinical Electrophysiology}. Amsterdam: Elsevier, 2024, roč.~10, č.~4, s.~654-666. ISSN~2405-500X. Dostupné z: https://doi.org/10.1016/j.jacep.2023.12.002.

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