Higher radiation doses for treating recurrent ventricular tachycardia

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to evaluate the effectiveness of dose-escalated stereotactic arrhythmia radioablation in patients with recurrent ventricular tachycardia (VT). The study hypothesizes that higher radiation doses will promote transmural scar formation, which is believed to be crucial for reducing long-term VT recurrence rates. Participants will include those with structural heart disease who have previously failed catheter ablation attempts. The trial will assess the safety and efficacy of this approach compared to the standard single dose of 25 Gy.

Why it matters

Who can join: the full rules

Inclusion Criteria:

Patients with structural heart disease, in particular ischemic and non-ischemic cardiomyopathy: Implanted ICD and/or CRT-D. Prior ≥1 failed catheter ablation (with endocardial ± epicardial approach based on the substrate location and the ECG morphology of clinical VTs) procedure to control sustained monomorphic VT using currently recommended mapping and ablation techniques,2 or patients in whom ablation is not feasible. Reasons for lack of epicardial ablation and non-feasibility of catheter ablation must be specified. Sustained VT recurrence after catheter ablation on optimised antiarrhythmic medication.

Age ≥18 years. IRB-approved, written informed consent must be provided

Exclusion Criteria:

Patients with only premature ventricular contractions.

Patients with sustained VT/VF who demonstrate:

Acute myocardial infarction; Primary electrical disease (channelopathy); Reversible and treatable cause (e.g., drug-induced or intoxication) of VT that can be adequately addressed otherwise; A target that cannot be safely and precisely defined based on stereotactic radiotherapy accuracy requirements (e.g., anatomical interference from OARs, overlapping prior radiation therapy to the thoracic region); Pregnancy or breastfeeding; Inability to provide informed consent.

Where it's running

• University Hospital Ostrava
  Ostrava, Czechia Recruiting
• University Hospital Zurich
  Zurich, Canton of Zurich, Switzerland Recruiting
• Inselspital Bern
  Bern, Switzerland Recruiting

Study contacts

• Study coordinator: Nicolaus Andratschke, MD
• Email: nicolaus.andratschke@usz.ch
• Phone: 0041 44 255 4238

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.