Ablation of ventricular tachycardia by sterotactic radiation therapy

Ablation of ventricular tachycardia by sterotactic radiation therapy Till date, ablation of ventricular tachycardia is done by invasive catheter based mapping of arrhythmia focus within the ventricles. In a potentially path breaking report published in the New Enland Journal of Medicine, non invasive cardiac radiation for ablation of ventricular tachycardia in 5 patients has been described [1]. Ventricular tachycardia was induced by the already implanted cardioverter-defibrillator (ICD) and non invasive electrocardiographic imaging of the tachycardia obtained. Stereotactic body radiation therapy (SBRT) was done after standard simulation, planning and treatment procols. Treatment efficacy was assessed by counting the episodes of ventricular tachycardia recorded by the ICD. Assessment of safety of the procedure was done by serial imaging of the heart and thorax for any potential collateral damage. The mean non invasive ablation time in the five patients was 14 minutes (range 11-18 minutes). Single fraction of 25 Gy radiation was delivered in the awake state. Patients had a total of 6577 episodes of ventricular tachycardia (VT) in the 3 months prior to treatment. 680 episodes of VT were recorded during the 6 week blanking period, which could be attributed to the inflammatory process after ablation and consequent ventricular irritability. After the blanking period, only 4 episodes of VT over the next 46 patient-months, indicating a 99.96% reduction, which electrophysiologists s...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology ECG / Electrophysiology Source Type: blogs