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Kästner, Lena [Verfasser:in]; Boda-Heggemann, Judit [Verfasser:in]; Fanslau, Hannah [Verfasser:in]; Xie, Jingyang [Verfasser:in]; Schweikard, Achim [Verfasser:in]; Giordano, Frank Anton [Verfasser:in]; Blanck, Oliver [Verfasser:in]; Rudic, Boris [Verfasser:in]

Electroanatomical mapping after cardiac radioablation for treatment of incessant electrical storm

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  • Medientyp: E-Artikel
  • Titel: Electroanatomical mapping after cardiac radioablation for treatment of incessant electrical storm : a case report from the RAVENTA trial
  • Beteiligte: Kästner, Lena [Verfasser:in]; Boda-Heggemann, Judit [Verfasser:in]; Fanslau, Hannah [Verfasser:in]; Xie, Jingyang [Verfasser:in]; Schweikard, Achim [Verfasser:in]; Giordano, Frank Anton [Verfasser:in]; Blanck, Oliver [Verfasser:in]; Rudic, Boris [Verfasser:in]
  • Erschienen: 12 September 2023
  • Erschienen in: Strahlentherapie und Onkologie ; 199(2023), 11, Seite 1018-1024
  • Sprache: Englisch
  • DOI: 10.1007/s00066-023-02136-z
  • Identifikator:
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: Background Electroanatomical mapping (EAM)-guided stereotactic arrhythmia radioablation (STAR) is a novel noninvasive therapy option for patients with monomorphic ventricular tachycardia (VT) refractory to antiarrhythmic drugs and/or urgent catheter ablation (CA). Data on success rates in an emergency situation such as electrical storm (ES) are rare. We present a case of a patient with an initially very poor life expectancy after extensive myocardial infarction with therapy-resistant ES, not amendable for further antiarrhythmic drug therapy, implantable cardioverter-defibrillator implantation, or repeated CA who was introduced to the radiation oncology department for emergency STAR as a bail-out therapy. - Methods Target volume definition and transfer from EAM to CT were validated and quality assured with a semi-automatic, dedicated visualization tool (CARDIO-RT). Emergency STAR was performed with 25 Gy in the framework of the RAVENTA study. The VT burden gradually decreased after STAR; however, a second VT morphology occurred, which was successfully treated with EAM-guided CA 12 days after STAR. - Results The second EAM-guided CA showed areas of low voltage in the irradiated segments, indicating a precise targeting and early functional response to STAR. The patient remained free of any VT recurrence or any radiation-related toxicities and in good general condition during the recent follow-up of 18 months. - Conclusion The case highlights the possible approach, caveats, difficulties, and prognosis of a patient severely affected by therapy-resistant VT in whom CA could not lead to VT suppression. Further studies of putative mechanisms of STAR in the acute and chronic phase of this novel therapy are warranted.
  • Zugangsstatus: Freier Zugang