Stereotaktična radioterapija za zdravljenje refraktarne prekatne tahikardije
A series of case reports on stereotactic body radiation for the treatment of refractory ventricular tachycardia

prikaz primerov

Authors

  • Tamara Jarm Univerza v Ljubljani, Medicinska fakulteta
  • Krištof Knap Univerzitetni klinični center Ljubljana
  • Bor Antolič Univerzitetni klinični center Ljubljana
  • Boštjan Berlot Univerzitetni klinični center Ljubljana
  • Rihard Hudej Onkološki inštitut Ljubljana
  • Aljaša Jenko Onkološki inštitut Ljubljana
  • Ajra Šečerov Ermenc Univerza v Ljubljani, Medicinska fakulteta; Onkološki inštitut Ljubljana
  • Jasna But-Hadžić Univerza v Ljubljani, Medicinska fakulteta; Onkološki inštitut Ljubljana
  • Ivica Ratoša Univerza v Ljubljani, Medicinska fakulteta; Onkološki inštitut Ljubljana

DOI:

https://doi.org/10.25670/oi2023-010on

Keywords:

radiotherapy, stereotactic radiotherapy, arrhythmias, ventricular tachycardia, cardiac radioablation, case report

Abstract

Stereotaktična radioterapija aritmij (STAR) predstavlja novo in obetavno možnost za bolnike z refraktarno prekatno tahikardijo, ki je odporna proti konvencionalnim metodam zdravljenja. STAR omogoča natančno neinvazivno ablacijo aritmogenega substrata ob minimalni prizadetosti sosednjih organov. Ta metoda zdravljenja je uporabna za bolnike, pri katerih je tarčno tkivo s katetrsko ablacijo nedosegljivo, pogosti šoki implantabilnega kardioverter-defibrilatorja pa močno nižajo njihovo kakovost življenja ali kadar sta ti metodi zdravljenja zaradi slabega zdravstvenega stanja kontraindicirani. Tarčo obsevanja (predel levega prekata) natančno opredelimo s predhodno slikovno diagnostiko, elektrokardiogramom, posnetki prekatne tahikardije in po potrebi invazivnim ali neinvazivnim elektrofiziološkim mapiranjem srca. Po pripravi na obsevanje na simulatorju sledi enkratno obsevanje z visokim odmerkom 25 Gy, ki je trenutno edina standardna frakcionacija. Bolniki obsevanje dobro prenašajo. Dosedanje raziskave so poročale o dobri učinkovitosti zdravljenja z bistvenim zmanjšanjem pogostosti epizod prekatne tahikardije in brez večjih neželenih učinkov. Poročamo o prvi skupini štirih bolnikov z visokorizično refraktarno prekatno tahikardijo, ki so bili zdravljeni s stereotaktično radioterapijo na Onkološkem inštitutu Ljubljana. Izvedba STAR se je izkazala kot učinkovita metoda z nizko stopnjo akutnih neželenih učinkov in predstavlja novo možnost obravnave te ranljive skupine bolnikov v slovenskem prostoru.


Abstract (Eng)

The development of novel treatment methods is crucial for managing refractory ventricular tachycardia resistant to conventional therapies. Stereotactic arrhythmia radiotherapy holds promising potential for such patients, enabling precise non-invasive ablation of arrhythmogenic substrate with minimal damage to surrounding organs. This approach could be invaluable for patients in whom the target tissue is inaccessible through catheter ablation, frequent implantable cardioverter-defibrillator shocks significantly diminish their quality of life, or for those contraindicated for such treatment options due to poor health status. The target for irradiation is precisely defined through prior imaging diagnostics, ECGs of ventricular tachycardias and invasive or non-invasive electrophysiological mapping of the heart. After radiation treatment planning, irradiation of a single high dose of 25 Gy follows, which is generally well tolerated by the patients. Previous studies have reported good treatment efficacy, with a significant reduction in ventricular tachycardia episode frequency, while causing minimal side effects. We report on the first group of four patients with high-risk refractory ventricular tachycardia treated with stereotactic arrhythmia radiotherapy at the Institute of Oncology Ljubljana. This opens new possibilities for the treatment of this vulnerable patient group within the Slovenian healthcare system and contributes to the evolving field of radiotherapeutic treatment.

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Published

2023-12-13

How to Cite

Jarm, . T., Knap, K., Antolič, B., Berlot, B., Hudej, R., Jenko, A., Šečerov Ermenc, A., But-Hadžić, J., & Ratoša, I. (2023). A series of case reports on stereotactic body radiation for the treatment of refractory ventricular tachycardia: prikaz primerov . Onkologija : A Medical-Scientific Journal, 27(2), 56–60. https://doi.org/10.25670/oi2023-010on

Issue

Vol. 27 No. 2 (2023)

Section

Case Reports

License

Copyright (c) 2023 Tamara Jarm

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