Long-Term Results of the First Clinical Application of Stereotactic Radioablation Using a Linear Electron Accelerator for the Treatment of Ventricular Tachycardia.

Autor: Vaskovskii VA; A. V. Vishnevsky National Medical Research Center of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia. vvaskov03@mail.ru., Taimasova IA; A. V. Vishnevsky National Medical Research Center of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia., Artyukhina EA; A. V. Vishnevsky National Medical Research Center of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia., Antipina NA; N. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia., Golanov AV; N. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia., Usachev DY; N. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, Moscow, Russia., Revishvili AS; A. V. Vishnevsky National Medical Research Center of Surgery, Ministry of Health of the Russian Federation, Moscow, Russia.
Jazyk: angličtina
Zdroj: Bulletin of experimental biology and medicine [Bull Exp Biol Med] 2023 Mar; Vol. 174 (5), pp. 594-600. Date of Electronic Publication: 2023 Apr 13.
DOI: 10.1007/s10517-023-05753-x
Abstrakt: We present the first clinical application of non-invasive stereotaxic radioablation of ventricular tachycardia (VT) refractory to medical and surgical treatment. Based on the results of invasive navigational activation mapping, a pericicatrical zone in the interventricular septum associated with VT was verified. Radiosurgical irradiation of the target in the region of the interventricular septum and the posterior apical segment of the left ventricle was performed on a TrueBeam linear electron accelerator (Varian) in accordance with the segmental scheme of the left ventricle. Irradiation doses for 95% of the internal target volume (ITV, 17 cm 3 ) and planned target volume (PTV, 46 cm 3 ) (31.2 and 25 Gy, respectively) were delivered by two full coplanar arches in 1 session. Irradiation was performed during expiration using a respiratory control system. The loading dose to critical structures was within tolerance. The planned follow-up period is 6 months. According to remote monitoring, the intensity of VT paroxysms over 48 days after treatment was from daily to 2-3 per day. Then, the incidence of VT paroxysms decreased (1-3 per week), and from the 64th to the 185th day (the end of the observation period), no VT paroxysms were recorded, which suggests that the impact was highly precise, conformal, and involved the total wall thickness. No undesirable effects and damage to adjacent organs were observed.
(© 2023. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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