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Noninvasive Cardiac Radiation for Ablation of Ventricular Tachycardia

Worldwide, invasive catheter ablation is increasingly performed to treat ventricular tachycardia. The procedure is largely effective in the absence of ventricular scar (idiopathic ventricular tachycardia). However, catheter ablation for cardiomyopathic ventricular tachycardia is associated with recurrence rates as high as 50% at 6 months.
Recent advances have enabled noninvasive mapping of cardiac arrhythmias with electrocardiographic imaging and noninvasive delivery of precise ablative radiation with stereotactic body radiation therapy (SBRT). We combined these techniques to perform catheter-free, electrophysiology-guided, noninvasive cardiac radioablation for ventricular tachycardia.
In conclusion, in five patients with intractable ventricular tachycardia, the use of noninvasive stereotactic cardiac radiotherapy as an ablation technique resulted in a marked reduction in the burden of ventricular tachycardia after treatment.
Thus, if a noninvasive approach to ablation of ventricular tachycardia is shown to be safe and effective, it would be a potentially important therapeutic advance.

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