SABR: the new kid on the block for treatment of ventricular tachycardia?

Sudden cardiac death is responsible for 4-5 million annual deaths worldwide. The primary cause of sudden cardiac death is ventricular tachycardia (VT), a cardiac arrhythmia commonly seen in patients with structural heart disease and impaired ventricular function. Conventional VT treatment approaches include antiarrhythmic drugs (AAD), invasive catheter ablation and implantable cardioverter defibrillators (ICD). While these treatments are associated with improved patient survival, they only provide modest rhythm control in the longer term and often have a detrimental effect on quality of life.

Stereotactic ablative body radiotherapy (SABR) is increasingly used in oncological practice, achieving very high local tumour control rates with low toxicity, and has been widely adopted in the management of a range of cancers including lung, prostate, liver, kidney and pancreas. A phase I/II study demonstrated the potential for non-invasive cardiac SABR treatment to control VT where conventional treatment has failed.

SABR is an emerging alternative approach for the treatment of refractory VT. Here we present a patient with recurrent refractory VT as an illustration of the workflow processes required to deliver SABR treatment for this condition.

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