Why the study?
When a ventricular tachycardia circuit is deep in the myocardium, catheter ablation may not reach it, creating a need for new minimally invasive therapies.
Does stereotactic radiotherapy improve safety and reduce VT episodes in patients with refractory VT not cured by catheter ablation?
Does stereotactic radiotherapy improve safety and reduce VT episodes in patients with refractory VT not cured by catheter ablation?
This protocol outlines a feasibility study for stereotactic radiotherapy as a novel, minimally invasive treatment for refractory ventricular tachycardia in patients who have failed catheter ablation.
<ns3:p> <ns3:bold>Background:</ns3:bold> Currently, the standard curative treatment for ventricular tachycardia (VT) and ventricular fibrillation (VF) is radiofrequency catheter ablation. However, when the VT circuit is deep in the myocardium, the catheter may not be delivered, and a new, minimally invasive treatment using different energies is desired. </ns3:p> <ns3:p> <ns3:bold>Methods:</ns3:bold> This is a protocol paper for a feasibility study designed to provide stereotactic radiotherapy for refractory VT not cured by catheter ablation after at least one catheter ablation. The primary end point is to evaluate the short-term safety of this treatment and the secondary endpoint is to evaluate its efficacy as assessed by the reduction in VT episode. Cyberknife M6 radiosurgery system will be used for treatment, and the prescribed dose to the target will be 25Gy in one fraction. The study will be conducted on three patients. </ns3:p> <ns3:p> <ns3:bold>Conclusion:</ns3:bold> Since catheter ablation is the only treatment option for VT that is covered by insurance in Japan, there is currently no other treatment for VT/VF that cannot be cured by catheter ablation. We hope that this feasibility study will provide hope for patients who are currently under the stress of ICD activation. </ns3:p> <ns3:p> <ns3:bold>Trial registration:</ns3:bold> The study has been registered in the Japan Registry of Clinical Trials (jRCTs042230030). </ns3:p>
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Kawamura et al. (2023) studied this question.
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