Patient selection, ventricular tachycardia substrate delineation, and data transfer for stereotactic arrhythmia radioablation: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology and the Heart Rhythm Society
EP Europace, vol. 27
Abstract
Stereotactic arrhythmia radioablation (STAR) is a novel, non-invasive, and promising treatment option for ventricular arrhythmias (VAs). It has been applied in highly selected patients mainly as bailout procedure, when (multiple) catheter ablations, together with anti-arrhythmic drugs, were unable to control the VAs. Despite the increasing clinical use, there is still limited knowledge of the acute and long-term response of normal and diseased myocardium to STAR. Acute toxicity appeared to be reasonably low, but potential late adverse effects may be underreported. Among published studies, the provided methodological information is often limited, and patient selection, target volume definition, methods for determination and transfer of target volume, and techniques for treatment planning and execution differ across studies, hampering the pooling of data and comparison across studies. In addition, STAR requires close and new collaboration between clinical electrophysiologists and radiation oncologists, which is facilitated by shared knowledge in each collaborator's area of expertise and a common language. This clinical consensus statement provides uniform definition of cardiac target volumes. It aims to provide advice in patient selection for STAR including aetiology-specific aspects and advice in optimal cardiac target volume identification based on available evidence. Safety concerns and the advice for acute and long-term monitoring including the importance of standardized reporting and follow-up are covered by this document. Areas of uncertainty are listed, which require high-quality, reliable pre-clinical and clinical evidence before the expansion of STAR beyond clinical scenarios in which proven therapies are ineffective or unavailable.
Authors 19
-
Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Leiden University Medical Center , P.O. Box 9600, 2300 RC Leiden ,
Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands
-
Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Leiden University Medical Center , P.O. Box 9600, 2300 RC Leiden ,
Department of Cardiology, Leiden University Medical Center , Leiden , Netherlands
-
Affiliation as printed
Electrophysiology, Texas Cardiac Arrhythmia Institute , Austin, TX ,
Texas Cardiac Arrhythmia Institute , Austin, Texas , United States of America
-
Affiliation as printed
Department of Arrhythmology, Centro Cardiologico Monzino IRCCS , Milan ,
Centro Cardiologico Monzino IRCCS, Department of Arrhythmology , Milan , Italy
-
Centre Hospitalier Régional et Universitaire de Nancy
Affiliation as printed
CHU de Nancy, Cardiology, Institut Lorrain du Coeur et des Vaisseaux , Vandoeuvre Les Nancy ,
CHU de Nancy, Institut Lorrain du Coeur et des Vaisseaux, Vandoeuvre Les Nancy , France
-
Affiliation as printed
Radiation Oncology, University of Ostrava , Ostrava , Czech Republic
Heart Center Leipzig, Electrophysiology , Leipzig , Germany
-
Leipzig Heart Institute · Vanderbilt University Medical Center
Affiliation as printed
Electrophysiology, Heart Center Leipzig , Leipzig ,
Vanderbilt University Medical Center , Nashville, Tennessee , United States of America
-
University of California San Diego
Affiliation as printed
Division of Cardiology, Section of Cardiac Electrophysiology, University of California San Diego , La Jolla, CA ,
University of California San Diego, Division of Cardiology, Section of Cardiac Electrophysiology , La Jolla, California , United States of America
-
Institute of Clinical and Experimental Medicine
Affiliation as printed
Cardiology, Institute for Clinical and Experimental Medicine , Prague ,
Institute For Clinical and Experimental Medicine , Prague, Czechia
-
Institute of Clinical and Experimental Medicine · University College London
Affiliation as printed
Cardiology Department, University College London , London ,
Institute For Clinical and Experimental Medicine , Prague, Czechia
-
Hospital Universitario La Paz · University College London
Affiliation as printed
Cardiology, Hospital General La Paz , Madrid ,
University College London, Cardiology Department , London , United Kingdom
-
Emory University · Emory University Hospital
Affiliation as printed
Emory Electrophysiology, Electrophysiology Lab Director, EUH, Emory University Hospital , Atlanta, GA ,
Program Director, Emory Electrophysiology, Electrophysiology Lab Director, EUH, Emory University Hospital , Atlanta , United States of America
-
Centre Hospitalier Universitaire Vaudois
Affiliation as printed
Department of Cardiology, Lausanne University Hospital , CHUV, Lausanne ,
Department of Cardiology, Lausanne University Hospital, CHUV, Department of Cardiology , Lausanne , Switzerland
-
Queen Elizabeth II Health Sciences Centre
Affiliation as printed
QEII Health Sciences Center, Halifax Infirmary Site , Halifax, NS ,
QEII Health Sciences Center, Halifax Infirmary Site, Halifax , Nova Scotia , Canada
-
Centre Hospitalier Universitaire Vaudois
Affiliation as printed
Department of Cardiology, Service de Radio-Oncologie, Lausanne University Hospital , CHUV, Lausanne ,
Service de Radio-Oncologie, Lausanne University Hospital, CHUV, Department of Cardiology , Lausanne , Switzerland
-
Brigham and Women's Hospital · Harvard University · Institute of Clinical and Experimental Medicine
Affiliation as printed
Cardiology, Institute for Clinical and Experimental Medicine , Prague ,
Cardiac Electrophysiology, Brigham and Women’s Hospital, Associate Professor of Medicine, Harvard Medical School , Boston , United States of America
-
Vanderbilt University Medical Center
Affiliation as printed
Vanderbilt University Medical Center , Nashville, TN ,
-
Brigham and Women's Hospital · Harvard University
Affiliation as printed
Professor of Medicine, Cardiac Electrophysiology, Brigham and Women's Hospital , Harvard Medical School, Boston, MA ,
-
University of Bern · University Hospital of Bern
Affiliation as printed
Inselspital, Hôpital universitaire de Berne , Bern ,
Cited by 50 stored of 51
No patents citing this paper on Lens.org (checked 2026-10-11).