Chiu Michael H, Mitchell L Brent, Ploquin Nicolas, Faruqi Salman, Kuriachan Vikas P
Libin Cardiovascular Institute of Alberta, Department of Cardiac Sciences, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada.
CJC Open. 2020 Nov 13;3(3):236-247. doi: 10.1016/j.cjco.2020.11.006. eCollection 2021 Mar.
Cardiac tachyarrhythmias are a major cause of morbidity and mortality. Treatments for these tachyarrhythmias include antiarrhythmic drugs, catheter ablation, surgical ablation, cardiac implantable electronic devices, and cardiac transplantation. Each of these treatment approaches is effective in some patients but there is considerable room for improvement, particularly with respect to the most common of the tachydysrhythmias, atrial fibrillation, and the most dangerous of the tachydysrhythmias, ventricular tachycardia (VT) or ventricular fibrillation. Noninvasive stereotactic ablative radiation therapy is emerging as an effective treatment for refractory tachyarrhythmias. Animal models have shown successful ablation of arrhythmogenic myocardial substrates with minimal short-term complications. Studies of stereotactic radioablation involving patients with refractory VT have shown a reduction in VT recurrence and promising early safety data. In this review, we provide the background for the application of stereotactic arrhythmia radioablation therapy along with promising results from early applications of the technology.
心脏快速性心律失常是发病和死亡的主要原因。这些快速性心律失常的治疗方法包括抗心律失常药物、导管消融、手术消融、心脏植入式电子设备和心脏移植。这些治疗方法中的每一种在某些患者中都是有效的，但仍有很大的改进空间，特别是对于最常见的快速性心律失常——心房颤动，以及最危险的快速性心律失常——室性心动过速（VT）或心室颤动。非侵入性立体定向消融放射治疗正在成为难治性快速性心律失常的一种有效治疗方法。动物模型已显示可成功消融致心律失常心肌基质，且短期并发症极少。对难治性室性心动过速患者进行立体定向放射消融的研究表明，室性心动过速复发率降低，并且早期安全性数据很有前景。在本综述中，我们提供了立体定向心律失常放射消融治疗应用的背景以及该技术早期应用的有前景的结果。
