Cardiac Radiation Shows Promise as Safer Option to Repeat Ablation for Severe Heart Rhythm Issues

Radiation therapy may offer a comparable and possibly safer alternative to repeat catheter ablation for patients with severe abnormal heart rhythms that can no longer be controlled with medication.

In the first study to directly compare cardiac radiation with standard catheter ablation for ventricular tachycardia, patients treated with cardiac radiation experienced fewer complications with similar effectiveness at controlling disease than those treated with cardiac ablation. Findings of the retrospective analysis will be presented today at the American Society for Radiation Oncology (ASTRO) Annual Meeting and published in the International Journal of Radiation Oncology • biology • Physics (Red Journal).

“Several large,single-arm trials have confirmed that stereotactic radiation therapy is a safe and effective option for patients with recurrent ventricular tachycardia,but our study is the first to measure outcomes from cardiac radiation directly against those from standard catheter ablation,” said Shannon Jiang,MD,lead author of the study and a radiation oncology resident physician at Washington university School of Medicine in St. Louis. “For patients who do not respond to traditional therapies and are at high risk of complications, noninvasive radiation may be a safer alternative to repeating an invasive catheter ablation procedure.”

Ventricular tachycardia (VT) is a hazardous disturbance of the heart’s rhythm that is associated with considerable morbidity and mortality. Patients with advanced VT frequently enough live with a heavy disease burden, frequently requiring high doses of rhythm-controlling drugs that cause tough side effects, implantable defibrillators that deliver powerful shocks when the heart slips into arrythmia, and hospital stays that add further physical and psychological strain.

Management becomes especially challenging when VT no longer responds to medication or initial ablation procedures. Patients in this stage, known as refractory or end-stage VT, are frequently enough medically fragile and at high risk for complications from further invasive procedures.Catheter ablation, the standard treatment for VT that is not responsive to medication, requires anesthesia and threading a small tube into the heart through a vein in the leg to destroy abnormal heart tissue. While effective for some, repeat procedures carry increasing risks.

In recent years, stereotactic arrhythmia radiation therapy (also known as STAR) has emerged as a novel, noninvasive alternative. By precisely delivering pinpoint beams of radiation to the scarred tissue that drives the abnormal heart rhythm, it aims to achieve the same goal as ablation – bringing the heart back into normal rhythm – without invasive catheters or anesthesia.

In the landmark ENCORE-VT trial previously published by the Washington University team,cardiac radiation reduced VT episodes and anti-arrhythmic drug use with modest short-term effects,and improved quality of life. Dr. jiang and colleagues designed the new analysis to add comparative evidence on radiation versus ablation, and also to report on longer-term results.

In the new study, they retrospectively analyzed records from 43 patients with high-risk re

Publication Date: 2025/09/30 03:11:32