Stereotactic arrhythmia radioablation for refractory ventricular tachycardia
the STOPSTORM.eu study.
The European STOPSTORM registry followed 193 patients (88% male, 53% non-ischaemic cardiomyopathy) treated with stereotactic arrhythmia radioablation (STAR) for refractory ventricular tachycardia. Among 107 patients with ≥6-month follow-up, median VT burden fell 80% over the six months after STAR and 72% remained free of ICD shocks. Twelve serious adverse events were adjudicated as possibly or probably treatment-related (including pericardial effusion and coronary events); 12-month overall survival was 77%.
Methods
STOPSTORM is a European prospective, international, multicentre registry of patients treated with STAR. The primary efficacy endpoint was the change in sustained VT episode burden comparing the 6 months before versus the 6 months after STAR. The primary safety endpoint was the occurrence of serious adverse events (SAEs) adjudicated as possibly or probably treatment-related. Overall survival was assessed using time-to-event methods.
Results
Across 28 centres, 193 patients were included (mean age 68±9 years; 88% male; 53% non-ischaemic cardiomyopathy). Median follow-up was 19 months. Among 107 evaluable patients with ≥6-month follow-up, the median VT episode burden was reduced by 80% after STAR. Among patients surviving ≥6 months, 72% were free from implantable cardioverter-defibrillator (ICD) shock. In the full cohort, 12 SAEs were adjudicated as possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Overall survival probability was 77% at 12 months.
Conclusions
In the largest prospective multicentre cohort reported to date, STAR was associated with a substantial reduction in VT burden and ICD shocks, with a low frequency of possibly or probably treatment-related SAEs.
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