Department of Radiation Oncology, General Regional Hospital "F. Miulli", Strada Prov 127, 70021, Acquaviva delle Fonti, Bari, Italy.
Department of Cardiology, General Regional Hospital "F. Miulli", Acquaviva delle Fonti, Bari, Italy.
Radiol Med. 2021 Jan;126(1):155-162. doi: 10.1007/s11547-020-01218-7. Epub 2020 May 13.
Stereotactic ablative radiation therapy (SABR) is used in non-oncologic indications, recently even for cardiac arrhythmias. Thus, aim of this analysis is to review preclinical, early clinical evidences and future direction of the latter new treatment approach.
A collection of available data regarding SABR and cardiac arrhythmias was made, by Pubmed research and 2 independent researchers, including preclinical and clinical data. A review of ongoing trials was conducted on ClinicalTrials.gov.
Preclinical research conducted in animal models showed that a safe and effective noninvasive treatment approach for cardiac arrhythmias could be represented by SABR with a median time of response around 2-3 months. The treatment dose plays a crucial role: the atrioventricular node would seem more radiosensitive than the other cardiac electric zones. Clinical data, such as published case series, case reports and early prospective studies, have already suggested the feasibility, efficacy and safety of SABR (25 Gy in one session) for refractory ventricular arrhythmias.
Considering the ongoing trials of SABR and new technological improvements in radiotherapy (e.g. hybrid magnetic resonance) and in arrhythmias noninvasive mapping systems, the future analyses will improve the reliability of those preliminary results.
立体定向消融放射治疗（SABR）被用于非肿瘤适应证，最近甚至用于治疗心律失常。因此，本分析的目的是回顾后者这种新治疗方法的临床前、早期临床证据和未来方向。
通过 Pubmed 研究和 2 位独立研究人员，对 SABR 和心律失常相关的现有数据进行了收集，包括临床前和临床数据。在 ClinicalTrials.gov 上对正在进行的试验进行了综述。
在动物模型中进行的临床前研究表明，SABR 可能是一种安全有效的心律失常非侵入性治疗方法，其反应中位数时间约为 2-3 个月。治疗剂量起着至关重要的作用：房室结似乎比其他心脏电区更敏感。临床数据，如已发表的病例系列、病例报告和早期前瞻性研究，已经表明 SABR（单次 25Gy）治疗难治性室性心律失常的可行性、疗效和安全性。
考虑到 SABR 的正在进行的试验以及放射治疗（例如混合磁共振）和心律失常非侵入性映射系统的新技术改进，未来的分析将提高这些初步结果的可靠性。
