Stereotactic cardiac radioablation for refractory ventricular tachycardia - electrical properties and conduction velocity analysis

Q: What does this research mean for the field?

Stereotactic cardiac radioablation decreases myocardial voltage amplitudes and predominantly reduces local conduction velocity within targeted high-dose myocardial tissue in patients with refractory ventricular tachycardia. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

T K Jadczyk; S Williams; V Markides; E Pruvot; J Solana Muno; P Peichl; J Cvek; P G Postema; W Hoeksema; V Vigneswaran; A Gharaviri; A Von Kietzell; K Malaczynska-Rajpold; O Blanck; J Whitaker

doi:10.1093/europace/euag105.1103

June 1, 2026EP EuropaceOpen Access

Stereotactic cardiac radioablation for refractory ventricular tachycardia - electrical properties and conduction velocity analysis

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Why the study?

Although stereotactic cardiac radioablation decreases refractory VT burden, the mechanism underlying its rapid antiarrhythmic effect remains uncertain and human electrophysiological data are scarce.

Does stereotactic cardiac radioablation reduce myocardial voltage and conduction velocity in patients with refractory ventricular tachycardia?

Key Points

This research aims to investigate the impact of stereotactic cardiac radioablation on myocardial voltage and conduction velocity in patients with refractory ventricular tachycardia.
Electroanatomical maps were taken from patients before and after cRA treatment across European centres in the STOPSTORM consortium.
Voltage and conduction velocity were analyzed using high-density electroanatomical mapping data pre- and post-cRA.
Data was processed by aligning anatomy and dose distribution maps, and local bipolar and unipolar voltages, along with conduction velocity, were computed.
Median bipolar voltage decreased from 1.94 mV to 0.51 mV (Δ=-1.43 mV, p<0.001).
Median unipolar voltage decreased from 4.87 mV to 2.74 mV (Δ=-2.13 mV, p<0.001).
Median conduction velocity diminished from 0.41 m/s to 0.22 m/s (Δ=-0.19 m/s, p<0.001) with one patient showing a unique increase.

Structured PICO

Does stereotactic cardiac radioablation reduce myocardial voltage and conduction velocity in patients with refractory ventricular tachycardia?

P

Population

15 patients with refractory ventricular tachycardia (VT) from European centres participating in the STOPSTORM consortium.

I

Intervention

Stereotactic cardiac radioablation (cRA) targeting myocardial regions receiving ≥20 Gy.

C

Comparator

Pre-cRA baseline (intra-patient comparison).

O

Outcome

Myocardial voltage (bipolar and unipolar) and conduction velocity (CV) within the ≥20 Gy isodose volume.surrogate

Stereotactic cardiac radioablation significantly reduces myocardial voltage and conduction velocity in targeted regions, providing mechanistic insight into its antiarrhythmic effects in humans.

Limitations

Small sample size (conduction velocity analysis feasible in only 8 patients)
Observational data

Implication

Voltage drop after radioablation may mark lesion formation; hypothesis-generating and leaves open arrhythmia outcomes in larger trials.

Abstract

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Cite This Study

Jadczyk et al. (2026) studied this question.

synapsesocial.com/papers/6a3f97e8125782b61d865b09 https://doi.org/10.1093/europace/euag105.1103

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Stereotactic cardiac radioablation for refractory ventricular tachycardia - electrical properties and conduction velocity analysis

Figures

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Stereotactic cardiac radioablation for refractory ventricular tachycardia - electrical properties and conduction velocity analysis

Figures

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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