ASTRO: Stereotactic Arrhythmia RT Safer Than Repeat Catheter Ablation for High-Risk Ventricular Tachycardia

MONDAY, Oct. 6, 2025 (HealthDay News) — For patients with ventricular tachycardia (VT), stereotactic arrhythmia radiotherapy (STAR) may be a comparable and safer alternative to repeat catheter ablation (CA), according to a study presented at the annual meeting of the American Society for Radiation Oncology (ASTRO), held from Sept. 27 to Oct. 1 in San Francisco.

Shannon Jiang, M.D., from the Washington University School of Medicine in St. Louis, and colleagues reported three-year outcomes for patients treated with STAR versus CA for high-risk VT between 2015 and 2018. Patients were followed for serious adverse events (SAEs), overall survival (OS), and freedom from death, shock, or storm (FFDSS).

The study included 43 patients: 22 treated with STAR (18 failed prior CA) and 21 with repeat CA (all failed previous CA). The researchers found that STAR recipients had superior median time of FFDSS versus CA (6.9 versus 2.9 months). FFDSS was 32 versus 27 percent, 27 versus 27 percent, and 18 versus 21 percent at one, two, and three years, respectively, for STAR versus CA. One-year treatment-related SAE developed in more CA than STAR recipients (38 versus 14 percent). The median time to any SAE was shorter for patients treated with CA versus STAR (0.2 versus 10.0 months); most early CA deaths occurred immediately after an SAE. Nine of the 12 STAR recipients who died within three years died from causes unrelated to VT; none died from treatment-related SAEs. For STAR versus CA, median OS was longer (28.2 versus 12.2 months); one-, two-, and three-year OS was 73 versus 58 percent, 55 versus 45 percent, and 45 percent for both, respectively.

“I think this study highlights that radiation being a noninvasive procedure helps us avoid a great deal of risk,” Jiang said in a statement.

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