A case report of successful elimination of recurrent ventricular tachycardia by repeated stereotactic radiotherapy: the importance of accurate target volume delineation

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F21%3A00081048" target="_blank" >RIV/00023001:_____/21:00081048 - isvavai.cz</a>

Alternative codes found

RIV/00843989:_____/21:E0108876 RIV/00216208:11110/21:10428581

Result on the web

<a href="https://academic.oup.com/ehjcr/article/5/2/ytaa516/6053690" target="_blank" >https://academic.oup.com/ehjcr/article/5/2/ytaa516/6053690</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/ehjcr/ytaa516" target="_blank" >10.1093/ehjcr/ytaa516</a>

Result language

angličtina

Original language name

A case report of successful elimination of recurrent ventricular tachycardia by repeated stereotactic radiotherapy: the importance of accurate target volume delineation

Original language description

Background Stereotactic body radiotherapy (SBRT) has emerged recently as a novel therapeutic alternative for patients with ventricular tachycardias (VTs) resistant to convetional treatment. Nevertheless, many aspects related to SBRT are currently unknown. Case summary A 66-year-old man with ischaemic heart disease, a history of coronary artery bypass graft surgery and left ventricular dysfunction was referred for recurrent symptomatic episodes of slow VT (108 b.p.m.). The arrhythmia was resistant to antiarrhythmic drug therapy with amiodarone and repeated catheter ablation. The patient was scheduled to SBRT, however, the first session failed to suppress VT recurrences. After 20 months, the patient underwent redo ablation procedure that revealed a newly developed scar with its core adjacent to the presumed critical part of the VT substrate. Catheter ablation again failed to eliminate VT and the second session of SBRT was scheduled. To improve targeting of the VT substrate for SBRT, we applied our recently developed original method for integration of data from the electroanatomical mapping system with computer tomography images. The second session of SBRT with precise targeting using the novel strategy led within 3 months to the successful elimination of VT. Discussion This case report describes a patient in whom the recurrent VT was abolished only by properly targeted SBRT. Above all, the case highlights the importance of precise identification and targeting for SBRT. Our case also documents in vivo, by electroanatomical voltage mapping, the development of SBRT-related myocardial lesion. This represents an important mechanistic proof of the concept of SBRT.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

<a href="/en/project/NU20-02-00244" target="_blank" >NU20-02-00244: STereotactic Ablative Radiosurgery of recurrent Ventricular Tachycardia in structural heart disease</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European heart journal. Case reports

ISSN

2514-2119

e-ISSN

—

Volume of the periodical

5

Issue of the periodical within the volume

2

Country of publishing house

GB - UNITED KINGDOM

Number of pages

5

Pages from-to

"art. no. ytaa516"

UT code for WoS article

000646067400015

EID of the result in the Scopus database

2-s2.0-85115213245