Stereotactic Radiotherapy in the Management of Ventricular Tachycardias: More Questions than Answers?

Key points • Stereotactic body radiotherapy (SBRT) is an attractive alternative treatment method for ventricular tachycardias recurring despite previous catheter ablation(s). • Initial clinical experience showed that cardiac SBRT using a single radiation dose of 25 Gy is feasible and may prevent or decrease the risk of ventricular tachycardia recurrences. • Although acute toxicity of SBRT is generally low, delayed side effects may limit wider acceptance of this strategy. • Many unanswered questions remain, including unknown mechanism of action, variable time to effect, the optimal method of substrate targeting, long-term safety, and definition of an optimal candidate for this treatment