Noninvasive Stereotactic Radiation for Refractory Ventricular Tachycardia After Failure of Cardiac Sympathetic Denervation

Hannah M Bernstein; William Leon; Megan E Daly; Peter Park; Ahmadreza Ghasemiesfe; Neil Beri; Maia Eng; Uma N Srivatsa

doi:10.1016/j.jaccas.2022.06.025

Noninvasive Stereotactic Radiation for Refractory Ventricular Tachycardia After Failure of Cardiac Sympathetic Denervation

JACC Case Rep. 2022 Sep 21;4(18):1189-1194. doi: 10.1016/j.jaccas.2022.06.025.

Authors

Hannah M Bernstein¹, William Leon¹, Megan E Daly², Peter Park², Ahmadreza Ghasemiesfe³, Neil Beri¹, Maia Eng¹, Uma N Srivatsa¹

Affiliations

¹ Division of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento, California, USA.
² Division of Radiation Oncology, University of California Davis Medical Center, Sacramento, California, USA.
³ Division of Radiology, University of California Davis Medical Center, Sacramento, California, USA.

Abstract

Stereotactic body radiation therapy is a novel treatment option for refractory ventricular tachycardia. We present a case of ventricular tachycardia, with epicardial origin located in large inferior infarct scar, that recurred despite treatment with multiple antiarrhythmic drugs, catheter ablation, and cardiac sympathetic denervation. Stereotactic body radiation therapy safely and effectively terminated the arrhythmia. (Level of Difficulty: Advanced.).

Keywords: 4DCT, 4-dimensional computed tomograph; CMR, cardiac magnetic resonance; CSD, cardiac sympathetic denervation; ICD, implantable cardioverter-defibrillator; PTV, planning target volume; SBRT, stereotactic body radiation therapy; VT, ventricular tachycardia; ablation; electrophysiology; stereotactic body radiation therapy; ventricular tachycardia.

Publication types

Case Reports