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Patient selection, ventricular tachycardia substrate delineation, and data transfer for stereotactic arrhythmia radioablation: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology and the Heart Rhythm Society
K. Zeppenfeld, R. Rademaker, A. Al-Ahmad, C. Carbucicchio, C. De Chillou, J. Cvek, M. Ebert, G. Ho, J. Kautzner, P. Lambiase, JL. Merino, M. Lloyd, S. Misra, E. Pruvot, J. Sapp, L. Schiappacasse, M. Sramko, WG. Stevenson, PC. Zei, D. Wichterle,...
Language English
Document type Journal Article, Practice Guideline
NLK
PubMed Central
from 2008
Open Access Digital Library
from 1999-01-01
Medline Complete (EBSCOhost)
from 1999-01-01
Oxford Journals Open Access Collection
from 1999-01-01
- MeSH
- Action Potentials MeSH
- Cardiology * standards MeSH
- Tachycardia, Ventricular * physiopathology surgery diagnosis MeSH
- Consensus MeSH
- Humans MeSH
- Radiosurgery * adverse effects standards methods MeSH
- Risk Factors MeSH
- Patient Selection * MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Practice Guideline MeSH
- Geographicals
- Europe MeSH
Stereotactic arrhythmia radioablation (STAR) is a novel, non-invasive, and promising treatment option for ventricular arrhythmias (VAs). It has been applied in highly selected patients mainly as bailout procedure, when (multiple) catheter ablations, together with anti-arrhythmic drugs, were unable to control the VAs. Despite the increasing clinical use, there is still limited knowledge of the acute and long-term response of normal and diseased myocardium to STAR. Acute toxicity appeared to be reasonably low, but potential late adverse effects may be underreported. Among published studies, the provided methodological information is often limited, and patient selection, target volume definition, methods for determination and transfer of target volume, and techniques for treatment planning and execution differ across studies, hampering the pooling of data and comparison across studies. In addition, STAR requires close and new collaboration between clinical electrophysiologists and radiation oncologists, which is facilitated by shared knowledge in each collaborator's area of expertise and a common language. This clinical consensus statement provides uniform definition of cardiac target volumes. It aims to provide advice in patient selection for STAR including aetiology-specific aspects and advice in optimal cardiac target volume identification based on available evidence. Safety concerns and the advice for acute and long-term monitoring including the importance of standardized reporting and follow-up are covered by this document. Areas of uncertainty are listed, which require high-quality, reliable pre-clinical and clinical evidence before the expansion of STAR beyond clinical scenarios in which proven therapies are ineffective or unavailable.
AGEL Hospital Trinec Podlesi Trinec Czech Republic
Assistant Professor of Medicine Johns Hopkins Medicine Division of Cardiology Baltimore MD USA
Atrium Health Sanger Heart Vascular Institute Kenilworth Charlotte NC USA
Cardiology Department Policlinico Gemelli Rome Italy
Cardiology Department University College London London UK
Cardiology Hospital General La Paz Madrid Spain
Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
CHU de Nancy Cardiology Institut Lorrain du Coeur et des Vaisseaux Vandoeuvre Les Nancy France
Department of Arrhythmology Centro Cardiologico Monzino IRCCS Milan Italy
Department of Cardiology Inselspital Bern University Hospital University of Bern Bern Switzerland
Department of Cardiology Lausanne University Hospital CHUV Lausanne Switzerland
Department of Clinical Electrophysiology and Pacing Monzino Cardiac Center Milan Italy
Department of Radiation Oncology Washington University School of Medicine St Louis MO USA
Electrophysiology Heart Center Leipzig Leipzig Germany
Electrophysiology Texas Cardiac Arrhythmia Institute Austin TX USA
Emory Electrophysiology Electrophysiology Lab Director EUH Emory University Hospital Atlanta GA USA
Faculty of Medicine Masaryk University Brno Czech Republic
Inselspital Hôpital universitaire de Berne Bern Switzerland
QEII Health Sciences Center Halifax Infirmary Site Halifax NS Canada
Radiation Oncology University of Ostrava Ostrava Czech Republic
References provided by Crossref.org
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