Noninvasive Cardiac Radioablation for Ventricular Arrhythmias

AbstractPurpose of ReviewIn this review, we describe the general principles and clinical use of stereotactic radioablation (SR) and its specific application to the treatment of malignant cardiac ventricular arrhythmias, or stereotactic arrhythmia radioablation (STAR). The principles of STAR, and the unmet needs in cardiac arrhythmia ablation are described. The basic pathophysiology of radioablative effect on cardiac tissues, the clinical experience to date, and future directions are discussed.Recent FindingsBasic preclinical research has demonstrated in large animal models (porcine, canine) that delivery of SR energy to cardiac targets, specifically left atrial ablation for atrial fibrillation, results in physiologic and histopathologic evidence of treatment effect without evidence of harm. Clinical treatments delivering SR to ventricular and atrial targets for ventricular tachycardia (VT) and atrial fibrillation (AF) have demonstrated clinical response without evidence of obvious harm or complication thus far.SummaryIn the nascent but exciting field of stereotactic radioablation for treatment of cardiac arrhythmias, preclinical evidence has demonstrated treatment effect without to date risk of significant collateral injury. In limited clinical experience treating both ventricular and atrial arrhythmias, clinical benefit in arrhythmia reduction without notable risk of complication has been observed. Further basic mechanistic research, refinement of delivery approaches, and fu...

Source: Current Cardiovascular Risk Reports - January 21, 2019 Category: Cardiology Source Type: research