Stereotactic Radiotherapy for the Management of Refractory Ventricular Tachycardia: Promise and Future Directions

Raphael Jumeau; Mahmut Ozsahin; Juerg Schwitter; Olgun Elicin; Tobias Reichlin; Laurent Roten; Nicolaus Andratschke; Michael Mayinger; Ardan M Saguner; Jan Steffel; Oliver Blanck; Marie-Catherine Vozenin; Raphael Moeckli; Michele Zeverino; Véronique Vallet; Claudia Herrera-Siklody; Patrizio Pascale; Jean Bourhis; Etienne Pruvot

doi:10.3389/fcvm.2020.00108

Stereotactic Radiotherapy for the Management of Refractory Ventricular Tachycardia: Promise and Future Directions

Front Cardiovasc Med. 2020 Jun 25:7:108. doi: 10.3389/fcvm.2020.00108. eCollection 2020.

Authors

Raphael Jumeau^{1

2}, Mahmut Ozsahin¹, Juerg Schwitter³, Olgun Elicin⁴, Tobias Reichlin⁵, Laurent Roten⁵, Nicolaus Andratschke⁶, Michael Mayinger⁶, Ardan M Saguner⁷, Jan Steffel⁷, Oliver Blanck⁸, Marie-Catherine Vozenin⁹, Raphael Moeckli¹⁰, Michele Zeverino¹⁰, Véronique Vallet¹⁰, Claudia Herrera-Siklody¹¹, Patrizio Pascale¹¹, Jean Bourhis¹, Etienne Pruvot¹¹

Affiliations

¹ Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
² Multidisciplinary Cancer Care Service, Radiation Oncology Unit, Riviera-Chablais Hospital, Rennaz, Switzerland.
³ Heart and Vessel Department, Cardiac MR Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁴ Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
⁵ Department of Cardiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
⁶ Department of Radiation Oncology, University Hospital Zurich, Zürich, Switzerland.
⁷ Department of Cardiology, University Heart Center Zurich, Zürich, Switzerland.
⁸ Department of Radiation Oncology and Department of Internal Medicine III, Cardiology, Section for Electrophysiology, University Medical Center Schleswig-Holstein, Kiel, Germany.
⁹ Radio-Oncology Research Laboratory, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
¹⁰ Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
¹¹ Heart and Vessel Department, Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Abstract

Ventricular tachycardia (VT) caused by myocardial scaring bears a significant risk of mortality and morbidity. Antiarrhythmic drug therapy (AAD) and catheter ablation remain the cornerstone of VT management, but both treatments have limited efficacy and potential adverse effects. Stereotactic body radiotherapy (SBRT) is routinely used in oncology to treat non-invasively solid tumors with high precision and efficacy. Recently, this technology has been evaluated for the treatment of VT. This review presents the basic underlying principles, proof of concept, and main results of trials and case series that used SBRT for the treatment of VT refractory to AAD and catheter ablation.

Keywords: ablation; noninvasive; radiotherapy; stereotactic radiotherapy; ventricular tachycardia.

Publication types

Review