TOPLINE:

In patients with treatment-refractory sustained ventricular tachycardia (VT), stereotactic arrhythmia radioablation (STAR) was associated with a substantial reduction in VT burden and implantable cardioverter-defibrillator (ICD) shocks, with a manageable safety profile and no treatment‑related deaths reported.

METHODOLOGY:

• Researchers performed a planned interim analysis using data from a prospective international registry that included 193 patients with treatment-refractory sustained VT enrolled across 28 European centers. The mean age was 68 years, and 88% were men.
• All patients underwent STAR between May 2021 and September 2025 after catheter ablation had failed, was deemed unsafe, or was unlikely to be beneficial. The median radiotherapy dose was 25 Gy in a single fraction, and the median follow-up was 19.1 months.
• The primary efficacy outcome was the change in sustained VT episodes or VT burden), comparing the 6 months before vs the 6 months after STAR.
• The primary safety outcome was the number of serious adverse events (SAEs) possibly or probably related to STAR.

TAKEAWAY:

• Among 107 evaluable patients with at least 6-month follow-up, the median VT burden reduced by 80% at 6 months after STAR; 61% of patients had a 50% reduction, 51% had a 75% reduction, and 32% had a 95% reduction.
• Among patients surviving beyond 6 months, 72% were free from ICD shock after STAR. At 12 months, VT-free survival was 11% and ICD-shock-free survival was 42%.
• Across the full cohort, 12 SAEs were considered as possibly or probably treatment related (0.06 events per patient). These included four probably treatment-related SAEs (two severe and two life-threatening) and eight possibly treatment-related SAEs (six severe and two life-threatening); no treatment‑related deaths were reported.
• At 12 months, the overall survival probability was 77%.

IN PRACTICE:

“With continued registry maturation, these data may help contextualize prior heterogeneous findings and support more standardized implementation of STAR in VT management,” the researchers of the study wrote.

SOURCE:

The study was led by Luuk H.G. van der Pol, University Medical Center Utrecht, Utrecht, Netherlands. It was published online on April 20 in European Heart Journal.

LIMITATIONS:

The study used a single‑arm registry design. The interim analysis included incomplete follow‑up for many patients, restricting the assessment of long‑term outcomes. Differences in procedural workflow, imaging, and treatment planning across centers may have influenced outcomes.

DISCLOSURES:

No specific funding sources or conflicts of interest were disclosed in the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.