The state-of-the-art technic of stereotactic radioablation for the treatment of cardiac arrhythmias: An overview

Cardiac arrhythmias are a leading cause of mortality, morbidity, and sudden cardiac death (SCD). Current treatment strategies for ventricular tachycardia (VT) are effective for many patients; however, in several cases, this does not result in a cure. Despite significant clinical improvements, conventional catheter ablation remains relatively unsuccessful in achieving the best outcomes in some challenging cases. Stereotactic arrhythmia radioablation (STAR), which delivers precise high-dose radiation to well-defined targets with minimal damage to surrounding tissue, is emerging as a new potential treatment option, having the potential to be used for patients at high risk for catheter ablation or who have refractory VT. Ongoing studies and preliminary experiences on f the efficacy of STAR in patients with refractory VT have shown a reduction in VT recurrence and a promising early safety profile. However, STAR is in its infancy, and clinical evidence on its efficacy and safety is limited; thus, conclusions regarding the efficacy of STAR should be drawn with caution. Further investigation of long-term efficacy and tolerability is ongoing to substantiate this promising therapeutic option better. The present review describes the background and general principles, pretreatment procedures, clinical implications, and toxicity of STAR therapy.