Stereotactic Radiotherapy for Treatment-Resistant Arrhythmias
Stereotactic Arrhythmia Radioablation (STAR) is an innovative method for treating arrhythmias that are resistant to conventional ablation techniques or cannot be controlled by these methods. STAR targets and destroys abnormal electrical pathways using radiation therapy.
Characteristics and Steps of the STAR Method
Patient Preparation and Planning:
- Imaging: The first step involves obtaining detailed images of the patient’s heart, typically using computed tomography (CT) or magnetic resonance imaging (MRI).
- Mapping: Electrical activity mapping is conducted, usually with electroanatomic mapping systems, to identify the sources of abnormal rhythms.
Treatment Planning:
- Targeting: Areas that are the sources of abnormal electrical signals are identified and targeted for radiation therapy.
- Dose Calculation: The radiation therapy team carefully calculates the radiation dose and treatment plan. The goal is to effectively target the abnormal tissues while minimizing damage to surrounding tissues.
Implementation of Stereotactic Radiotherapy:
- Patient Positioning: It is crucial to maintain the patient in the correct position during treatment, usually secured on a specialized table.
- Radiation Application: The stereotactic radiotherapy device precisely delivers radiation beams to the targeted area. This treatment is typically completed over several sessions.
Post-Treatment Monitoring:
- Assessment: Post-treatment, the patient’s arrhythmias are closely monitored and the effectiveness is evaluated. This is often done through electroanatomic mapping and regular ECG checks.
Conclusion
Stereotactic radiotherapy for treatment-resistant arrhythmias represents a significant innovation in modern medicine. This method offers a promising option for patients who are not suitable for or have failed conventional ablation methods. However, suitability for each patient should be determined through comprehensive evaluation and a multidisciplinary approach. STAR should be carefully planned by cardiologists and radiation oncologists, particularly in complex cases and high-risk patients.