October 1, 2026JACC. Clinical electrophysiology
Stereotactic Body Radiation Therapy for VT in Chagas Cardiomyopathy
Key result
SBRT reduces refractory VT burden in patients with Chagas cardiomyopathy.
- n=11
JACC. Clinical electrophysiology published a graphical abstract
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Why the study?
The role of stereotactic body radiation therapy (SBRT) for ventricular tachycardia in patients with chronic Chagas cardiomyopathy remains unexplored.
Does stereotactic body radiation therapy (SBRT) reduce VT burden and treatment-related adverse events in patients with chronic Chagas cardiomyopathy and refractory VT?
Structured PICO
Does stereotactic body radiation therapy (SBRT) reduce VT burden and treatment-related adverse events in patients with chronic Chagas cardiomyopathy and refractory VT?
P
Population
11 patients (mean age 64.9 years) with Chagas cardiomyopathy and refractory ventricular tachycardia who had failed or were ineligible for catheter ablation.
I
Intervention
A single 25-Gy fraction of stereotactic body radiation therapy (SBRT) delivered to an arrhythmogenic substrate identified by multimodality imaging.
O
Outcome
Reduction in VT burden and treatment-related adverse eventscomposite
Limitations
- High rate of VT recurrence
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“In many ways, Chagas may be an ideal cardiomyopathy to make use of noninvasive cardiac radioablation. First, the VT circuits in Chagas often traverse across the layers of myocardium, using epicardial, midmyocardial, and endocardial scar channels. An important advantage of cardiac radioablation over catheter treatment is that radioablation is delivered across the full thickness of the scarred myocardium.”
Implication
SBRT is a feasible noninvasive approach that significantly reduces ventricular arrhythmia burden in patients with Chagas cardiomyopathy and refractory VT, although recurrence rates remain high.
Abstract
BACKGROUND: Stereotactic body radiation therapy (SBRT) is a novel noninvasive therapy for ventricular tachycardia (VT), but its role in Chagas cardiomyopathy remains unexplored. OBJECTIVES: This study aimed to evaluate the safety and preliminary efficacy of SBRT for refractory VT in patients with chronic Chagas cardiomyopathy. METHODS: We prospectively enrolled patients with Chagas cardiomyopathy and refractory VT who had failed or were ineligible for catheter ablation. A single 25-Gy fraction of SBRT was delivered to an arrhythmogenic substrate identified by multimodality imaging. The primary outcomes were a reduction in VT burden and treatment-related adverse events. RESULTS: Eleven patients (age: 64.9 ± 6.7 years; LVEF: 31.6 ± 9.8%) with implantable cardioverter-defibrillators, 9 of whom had prior failed ablations, underwent SBRT. The median internal target volume was 27.3 cm CONCLUSIONS: SBRT is a feasible approach for refractory VT in Chagas cardiomyopathy. Despite a high rate of VT recurrence, SBRT statistically significantly reduced the burden of ventricular arrhythmia, warranting further investigation.
Discussion
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Cite This Study
Salvajoli et al. (2026) studied Chagas cardiomyopathy and refractory ventricular tachycardia (n=11). Stereotactic body radiation therapy (SBRT) was evaluated on Reduction in VT burden and treatment-related adverse events. Stereotactic body radiation therapy (SBRT) statistically significantly reduced the burden of ventricular arrhythmia in patients with Chagas cardiomyopathy and refractory VT.