Long-term results of stereotactic arrhythmia radioablation for refractory ventricular Arrhythmias-A Taiwanese population study.

IF 2.6 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
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, Jyh-Ming Jimmy Juang, Lian-Yu Lin
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Abstract

Background: Stereotactic 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.

Methods: This 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.

Results: From 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.

Conclusions: In 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.

立体定向心律失常放射消融术治疗难治性室性心律失常的远期疗效:台湾人群研究。
背景:立体定向心律失常放射消融术(STAR)已被证明对难治性室性心动过速(VT)有效。我们报告一组台湾患者在亚洲首次STAR系列治疗难治性室血栓的长期结果。方法:本研究前瞻性地招募了治疗失败的VT患者,使用3D电解剖图、延迟增强磁共振成像和双能计算机断层扫描来识别疤痕基质。主要靶体积由Varian/Edge TrueBeam系统提供25 Gy的单次辐射剂量。通过植入式心律转复除颤器记录的VT事件评估疗效。结果:2019年2月至2023年2月,纳入11例患者,随访1年以上。10名男性和1名女性患者接受了治疗。在53个月的中位随访期间,VT发作在治疗后的前6个月减少了88%。大多数患者均出现晚期室速复发。5例患者接受反复导管消融治疗复发性室性心动过速。1年生存率为83%。存活患者中1例接受心脏移植,2例接受心脏伴侣III型植入术。结论:在药物治疗和导管消融的难治性室速患者中,STAR与室速负担的显著急性减轻相关。室速负担减轻的急性反应有助于患者进入心力衰竭的下一个治疗步骤,包括医疗优化或手术治疗,并提高临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.50
自引率
6.20%
发文量
381
审稿时长
57 days
期刊介绍: Journal of the Formosan Medical Association (JFMA), published continuously since 1902, is an open access international general medical journal of the Formosan Medical Association based in Taipei, Taiwan. It is indexed in Current Contents/ Clinical Medicine, Medline, ciSearch, CAB Abstracts, Embase, SIIC Data Bases, Research Alert, BIOSIS, Biological Abstracts, Scopus and ScienceDirect. As a general medical journal, research related to clinical practice and research in all fields of medicine and related disciplines are considered for publication. Article types considered include perspectives, reviews, original papers, case reports, brief communications, correspondence and letters to the editor.
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