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The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes

Background: among cardiac arrhythmias, ventricular tachycardia (VT) is one that can lead to cardiac death, although significant progress has been made in its treatment, including the use of implantable cardioverter-defibrillators (ICD) and radiofrequency catheter ablation. Nevertheless, long-term re...

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Autores principales: Cozzi, Salvatore, Bottoni, Nicola, Botti, Andrea, Trojani, Valeria, Alì, Emanuele, Finocchi Ghersi, Sebastiano, Cremaschi, Federica, Iori, Federico, Ciammella, Patrizia, Iori, Mauro, Iotti, Cinzia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694192/
https://www.ncbi.nlm.nih.gov/pubmed/36579492
http://dx.doi.org/10.3390/jpm12111783
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author Cozzi, Salvatore
Bottoni, Nicola
Botti, Andrea
Trojani, Valeria
Alì, Emanuele
Finocchi Ghersi, Sebastiano
Cremaschi, Federica
Iori, Federico
Ciammella, Patrizia
Iori, Mauro
Iotti, Cinzia
author_facet Cozzi, Salvatore
Bottoni, Nicola
Botti, Andrea
Trojani, Valeria
Alì, Emanuele
Finocchi Ghersi, Sebastiano
Cremaschi, Federica
Iori, Federico
Ciammella, Patrizia
Iori, Mauro
Iotti, Cinzia
author_sort Cozzi, Salvatore
collection PubMed
description Background: among cardiac arrhythmias, ventricular tachycardia (VT) is one that can lead to cardiac death, although significant progress has been made in its treatment, including the use of implantable cardioverter-defibrillators (ICD) and radiofrequency catheter ablation. Nevertheless, long-term recurrence rates remain in about half of patients and drastically impact the patient’s quality of life. Moreover, recurrent ICD shocks are painful and are associated with higher mortality and worsening of heart failure. Recently, more and more experiences are demonstrating potential efficacy in the use of stereotactic body radiotherapy (SBRT) (also called cardiac radio-ablation) to treat this condition. In this paper, we report our experience in the use of cardiac radio-ablation for the treatment of refractory ventricular tachycardia with a focus on the technique used, along with a review of the literature and technical notes. Case presentation: an 81-year-old male patient with a long history of non-ischemic dilated cardiomyopathy and mechanical mitral prosthesis underwent a biventricular cardioverter defibrillator implant after atrial ventricular node ablation. At the end of 2021, the number of tachycardias increased significantly to about 10 episodes per day. After failure of medical treatment and conventional RT catheter ablation, the patient was treated with SBRT for a total dose of 25 Gy in a single session at the site of the ectopic focus. No acute toxicity was recorded. After SBRT (follow-up 7 months) no other VT episodes were recorded. Conclusion: SBRT appears to be safe and leads to a rapid reduction in arrhythmic storms as treatment for VT without acute toxicity, representing one of the most promising methods for treating VT storms.
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spelling pubmed-96941922022-11-26 The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes Cozzi, Salvatore Bottoni, Nicola Botti, Andrea Trojani, Valeria Alì, Emanuele Finocchi Ghersi, Sebastiano Cremaschi, Federica Iori, Federico Ciammella, Patrizia Iori, Mauro Iotti, Cinzia J Pers Med Case Report Background: among cardiac arrhythmias, ventricular tachycardia (VT) is one that can lead to cardiac death, although significant progress has been made in its treatment, including the use of implantable cardioverter-defibrillators (ICD) and radiofrequency catheter ablation. Nevertheless, long-term recurrence rates remain in about half of patients and drastically impact the patient’s quality of life. Moreover, recurrent ICD shocks are painful and are associated with higher mortality and worsening of heart failure. Recently, more and more experiences are demonstrating potential efficacy in the use of stereotactic body radiotherapy (SBRT) (also called cardiac radio-ablation) to treat this condition. In this paper, we report our experience in the use of cardiac radio-ablation for the treatment of refractory ventricular tachycardia with a focus on the technique used, along with a review of the literature and technical notes. Case presentation: an 81-year-old male patient with a long history of non-ischemic dilated cardiomyopathy and mechanical mitral prosthesis underwent a biventricular cardioverter defibrillator implant after atrial ventricular node ablation. At the end of 2021, the number of tachycardias increased significantly to about 10 episodes per day. After failure of medical treatment and conventional RT catheter ablation, the patient was treated with SBRT for a total dose of 25 Gy in a single session at the site of the ectopic focus. No acute toxicity was recorded. After SBRT (follow-up 7 months) no other VT episodes were recorded. Conclusion: SBRT appears to be safe and leads to a rapid reduction in arrhythmic storms as treatment for VT without acute toxicity, representing one of the most promising methods for treating VT storms. MDPI 2022-10-28 /pmc/articles/PMC9694192/ /pubmed/36579492 http://dx.doi.org/10.3390/jpm12111783 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Cozzi, Salvatore
Bottoni, Nicola
Botti, Andrea
Trojani, Valeria
Alì, Emanuele
Finocchi Ghersi, Sebastiano
Cremaschi, Federica
Iori, Federico
Ciammella, Patrizia
Iori, Mauro
Iotti, Cinzia
The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes
title The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes
title_full The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes
title_fullStr The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes
title_full_unstemmed The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes
title_short The Use of Cardiac Stereotactic Radiation Therapy (SBRT) to Manage Ventricular Tachycardia: A Case Report, Review of the Literature and Technical Notes
title_sort use of cardiac stereotactic radiation therapy (sbrt) to manage ventricular tachycardia: a case report, review of the literature and technical notes
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694192/
https://www.ncbi.nlm.nih.gov/pubmed/36579492
http://dx.doi.org/10.3390/jpm12111783
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