Stereotactic Management of Arrhythmia - Radiosurgery in Treatment of Ventricular Tachycardia
Stereotactic Management of Arrhythmia - Radiosurgery in Treatment of Ventricular Tachycardia
Prospective single-arm study investigating the safety of non-invasive cardiac radiosurgery
 for the treatment of ventricular tachycardia (VT).
The standard of care for the treatment of Ventricular Tachycardia (VT) comprises of
 pharmacotherapy, ICD implantation and electrophysiology-guided catheter ablation. The
 treatment, however, is associated with a relatively high risk of VT recurrence. Given the
 limited therapeutic options and significant impact on patients quality of life, non-invasive
 cardiac radiosurgery has been recently gaining popularity in scientific literature as a
 viable alternative to salvage catheter ablations. Considering the scarcity of data from
 prospective trials and concern about the safety of the treatment method, this trial seeks to
 determine whether Stereotactic Management of Arrhythmia - Radiosurgery in Treatment of
 Ventricular Tachycardia (SMART-VT) meets the expected safety requirements for clinical use.
Inclusion Criteria:

 -  Patients with structural heart disease and implantable cardioverter defibrillator
 (ICD)

 -  Clinically significant arrhythmia with at least 3 VT episodes per month despite
 adequate pharmacological treatment.

 -  At least one episode of monomorphic VT registered in electrophysiological examination.

 -  Recurrent VT despite at least one prior catheter ablation and adequate pharmacotherapy
 OR contraindications to catheter ablation and/or pharmacotherapy (i.e., patient with
 medically contraindicated catheter ablation is obliged to undergo only pharmacotherapy
 prior to study enrollment).

 -  Patient must be able to understand and be willing to sign a written informed consent
 document.

 Exclusion Criteria:

 -  Heart failure requiring inotropic treatment or mechanical assistance

 -  Arrhythmia due to cardiac channelopathy

 -  Reversible source of arrhythmia

 -  NYHA (New York Heart Association) stage IV hearth failure

 -  Hearth infarction or cardiac surgery in last 3 months

 -  Life expectancy <6 months

 -  Polymorphic VT

 -  Pregnancy

 -  Prior radiotherapy to the thoracic region (relative contraindication)

 -  Failure to induce VT during electrophysiological examination