Evidence map›Paper›PMID 39716963›Full record

SynthesisEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024

Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review.

Amulya Gupta, Zeeshan Sattar, Nourhan Chaaban, Sagar Ranka, Cameron Carlson, Farhad Sami, Clifford G Robinson, Phillip S Cuculich, Seth H Sheldon, Madhu Reddy and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Stereotactic radioablation for ventricular tachycardia in patients untreatable by catheter ablation: evidence of efficacy, safety, and impact on coronary arteries.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  6. Article
  7. Article
  8. Rethinking imaging protocols, training models, and target delineation in cardiac radioablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  9. Article
  10. Excellent interobserver agreement and steep learning curve for target volume delineation for stereotactic arrhythmia radioablation using a commercial software.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  11. Article
  12. Review
  13. Article
  14. Aiming for the STARs: radiotherapy for ventricular tachycardia-bright future or cosmic gamble?Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Amulya GuptaDepartment of Cardiovascular Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 4023, Kansas City, KS 66160, USA.ORCID 0000-0001-5317-6024
Zeeshan SattarDepartment of General and Hospital Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.ORCID 0000-0003-0133-0645
Nourhan ChaabanDepartment of Internal Medicine, The University of Kansas School of Medicine, Wichita, KS, USA.
Sagar RankaDivision of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID 0000-0002-2167-6961
Cameron CarlsonUniversity of Denver, Natural Sciences and Mathematics, Denver, CO, USA.
Farhad SamiDivision of Cardiology, University of Iowa, Iowa City, IA, USA.ORCID 0000-0001-9464-6934
Clifford G RobinsonDepartment of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, USA.ORCID 0000-0002-1399-9904
Phillip S CuculichCardiovascular Division, Washington University in St. Louis, St. Louis, MO, USA.ORCID 0000-0001-8127-2240
Seth H SheldonDepartment of Cardiovascular Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 4023, Kansas City, KS 66160, USA.ORCID 0000-0003-0543-2040
Madhu ReddyDepartment of Cardiovascular Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 4023, Kansas City, KS 66160, USA.
David AkhavanDepartment of Radiation Oncology, The University of Kansas Medical Center, Kansas City, KS, USA.ORCID 0000-0001-9733-6069
Amit NoheriaDepartment of Cardiovascular Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 4023, Kansas City, KS 66160, USA.ORCID 0000-0002-9947-3849

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsAmong patients with structural heart disease with ventricular tachycardia (VT) refractory to medical therapy and catheter ablation, cardiac stereotactic body radiotherapy (SBRT) is a paradigm-changing treatment option. This study aims to assess the efficacy of cardiac SBRT in refractory VT by comparing the rates of VT episodes, anti-tachycardia pacing (ATP) therapies, and implantable cardioverter-defibrillator (ICD) shocks post-SBRT with pre-SBRT. METHODS AND

resultsWe performed a comprehensive literature search and included all clinical studies reporting outcomes on cardiac SBRT for VT. Treatment efficacy was evaluated as random-effects pooled rate-ratios of VT episodes, ATP therapies and ICD shocks post-SBRT (after 6-week blanking) and pre-SBRT, with patients serving as their own controls. Post-SBRT overall survival was assessed using Kaplan-Meier method. We included 23 studies published 2017-24 reporting on 225 patients who received cardiac SBRT, with median follow-up 5.8-28 months. There was significant heterogeneity among the studies for all three efficacy endpoints (P < 0.00001). The random-effects pooled rate-ratios of VT episodes, ATP therapies and ICD shocks post- vs. pre-SBRT were 0.10 (95% CI 0.06, 0.16), 0.09 (0.05, 0.15), and 0.09 (0.05, 0.17), respectively (all P < 0.00001). The most common reported complications included pericardial (8.0%, including 0.9% late oesophagogastro-pericardial fistula) and pulmonary (5.8%). There was no change in left ventricular ejection fraction post-SBRT (P = 0.3) but some studies reported an increase in mitral regurgitation. The combined 3-, 12-, and 24-month overall patient survival was 0.86 (0.80, 0.90), 0.72 (0.65, 0.78), and 0.57 (0.47, 0.67), respectively.

conclusionAmong patients with refractory VT in context of structural heart disease, VT burden and ICD shocks are dramatically reduced following cardiac SBRT. The overall mortality in this population with heart failure and refractory VT receiving palliative cardiac SBRT remains high.

Indexed as

RadiosurgeryTachycardia, VentricularCardiac Pacing, ArtificialDefibrillators, ImplantableElectric CountershockFemaleHumansMaleTreatment OutcomeCardiacMeta-analysisRadioablationRadiotherapySABRSBRTSTARStereotactic ablative body radiotherapyStereotactic arrhythmia radioablationStereotactic body radiotherapyVentricular tachycardiaVT

Identifiers

PMID39716963
PMCPMC11780863

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.