• Li-Ting Ho, Jenny Ling-Yu Chen, Jung-Chi Hsu, Hsing-Min Chan, Yu-Cheng Huang, Mao-Yuan Su, Sung-Hsin Kuo, Yeun-Chung Chang, Jiunn-Lee Lin, Wen-Jone Chen, Wen-Jeng Lee, JuangJyh-Ming JimmyJJDivision of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Cardiovascular center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan., and Lian-Yu Lin.
• Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Cardiovascular center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2024 Dec 2.

BackgroundStereotactic arrhythmia radioablation (STAR) has proven to be effective in refractory ventricular tachyarrhythmia (VT). We report the long-term results in first Asian series of STAR for refractory VT in a group of Taiwanese.MethodsThis study prospectively enrolled patients with treatment-failure VT. 3D electroanatomic maps, delayed enhancement magnetic resonance imaging and dual energy computed tomography were used to identify scar substrates. The main target volume was treated with a single radiation dose of 25 Gy delivered by Varian/Edge TrueBeam System. Efficacy was assessed by VT events recorded by implantable cardioverter defibrillator.ResultsFrom February 2019 to Feburary 2023, 11 patients were enrolled and followed up for at least 1 year. Ten male and one female patient received the treatment. During the median follow-up of 53 months, VT episodes decreased by 88% in post-treatment first 6 months. Late VT recurrence was observed in most of patients. Five patients received repeated catheter ablation for recurrent VTs. One-year survival rate was 83%. Among surviving patients, 1 received heart transplant and 2 had HeartMate III implantation.ConclusionsIn patients with medication and catheter ablation refractory VT, STAR is associated with a marked acute reduction in the burden of VT. The acute response of VT burden reduction helps to bridge patients to the next treatment step of heart failure, including medical optimization or surgical management, and enhance clinical outcomes.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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