A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis
IntroductionCatheter ablation (CA) is the current standard of care for patients suffering drug-refractory monomorphic ventricular tachycardias (MMVTs). Yet, despite significant technological improvements, recurrences remain common, leading to increased morbidity and mortality. Stereotactic arrhythmi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.934686/full |
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| author | Mario Levis Veronica Dusi Massimo Magnano Marzia Cerrato Elena Gallio Alessandro Depaoli Federico Ferraris Gaetano Maria De Ferrari Umberto Ricardi Matteo Anselmino |
| author_facet | Mario Levis Veronica Dusi Massimo Magnano Marzia Cerrato Elena Gallio Alessandro Depaoli Federico Ferraris Gaetano Maria De Ferrari Umberto Ricardi Matteo Anselmino |
| author_sort | Mario Levis |
| collection | DOAJ |
| description | IntroductionCatheter ablation (CA) is the current standard of care for patients suffering drug-refractory monomorphic ventricular tachycardias (MMVTs). Yet, despite significant technological improvements, recurrences remain common, leading to increased morbidity and mortality. Stereotactic arrhythmia radioablation (STAR) is increasingly being adopted to overcome the limitations of conventional CA, but its safety and efficacy are still under evaluation.Case presentationWe hereby present the case of a 73-year-old patient implanted with a mitral valve prosthesis, a cardiac resynchronization therapy-defibrillator, and a cardiac contractility modulation device, who was successfully treated with STAR for recurrent drug and CA-resistant MMVT in the setting of advanced heart failure and a giant left atrium. We report a 2-year follow-up and a detailed dosimetric analysis.ConclusionOur case report supports the early as well as the long-term efficacy of 25 Gy single-session STAR. Despite the concomitant severe heart failure, with an overall heart minus planned target volume mean dosage below 5 Gy, no major detrimental cardiac side effects were detected. To the best of our knowledge, our dosimetric analysis is the most accurate reported so far in the setting of STAR, particularly for what concerns cardiac substructures and coronary arteries. A shared dosimetric planning among centers performing STAR will be crucial in the next future to fully disclose its safety profile. |
| first_indexed | 2024-12-11T00:50:11Z |
| format | Article |
| id | doaj.art-99efe4d07d0342d6a89d8c42721112c4 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-11T00:50:11Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-99efe4d07d0342d6a89d8c42721112c42022-12-22T01:26:39ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-08-01910.3389/fcvm.2022.934686934686A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysisMario Levis0Veronica Dusi1Massimo Magnano2Marzia Cerrato3Elena Gallio4Alessandro Depaoli5Federico Ferraris6Gaetano Maria De Ferrari7Umberto Ricardi8Matteo Anselmino9Department of Oncology, University of Turin, Turin, ItalyDivision of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin, ItalyDivision of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin, ItalyDepartment of Oncology, University of Turin, Turin, ItalyMedical Physics Unit, Città della Salute e della Scienza Hospital, Turin, ItalyDepartment of Radiology, Città della Salute e della Scienza Hospital, Turin, ItalyDivision of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin, ItalyDivision of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin, ItalyDepartment of Oncology, University of Turin, Turin, ItalyDivision of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin, ItalyIntroductionCatheter ablation (CA) is the current standard of care for patients suffering drug-refractory monomorphic ventricular tachycardias (MMVTs). Yet, despite significant technological improvements, recurrences remain common, leading to increased morbidity and mortality. Stereotactic arrhythmia radioablation (STAR) is increasingly being adopted to overcome the limitations of conventional CA, but its safety and efficacy are still under evaluation.Case presentationWe hereby present the case of a 73-year-old patient implanted with a mitral valve prosthesis, a cardiac resynchronization therapy-defibrillator, and a cardiac contractility modulation device, who was successfully treated with STAR for recurrent drug and CA-resistant MMVT in the setting of advanced heart failure and a giant left atrium. We report a 2-year follow-up and a detailed dosimetric analysis.ConclusionOur case report supports the early as well as the long-term efficacy of 25 Gy single-session STAR. Despite the concomitant severe heart failure, with an overall heart minus planned target volume mean dosage below 5 Gy, no major detrimental cardiac side effects were detected. To the best of our knowledge, our dosimetric analysis is the most accurate reported so far in the setting of STAR, particularly for what concerns cardiac substructures and coronary arteries. A shared dosimetric planning among centers performing STAR will be crucial in the next future to fully disclose its safety profile.https://www.frontiersin.org/articles/10.3389/fcvm.2022.934686/fullcase reportstereotactic body radiation therapyventricular tachycardiaradiotherapycardiac contractility modulation |
| spellingShingle | Mario Levis Veronica Dusi Massimo Magnano Marzia Cerrato Elena Gallio Alessandro Depaoli Federico Ferraris Gaetano Maria De Ferrari Umberto Ricardi Matteo Anselmino A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis Frontiers in Cardiovascular Medicine case report stereotactic body radiation therapy ventricular tachycardia radiotherapy cardiac contractility modulation |
| title | A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis |
| title_full | A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis |
| title_fullStr | A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis |
| title_full_unstemmed | A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis |
| title_short | A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis |
| title_sort | case report of long term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium including a detailed dosimetric analysis |
| topic | case report stereotactic body radiation therapy ventricular tachycardia radiotherapy cardiac contractility modulation |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.934686/full |
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