Using targeted radiotherapy to treat difficult ventricular tachycardia

Stereotactic Ablative Radiotherapy for the Treatment of Refractory Ventricular Tachycardia

This study is testing a new non-invasive radiation treatment for people with hard-to-treat ventricular tachycardia to see if it can help reduce their heart rhythm problems.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 6 (estimated)
• Ages: 18 Years to 85 Years
• Sex: All
• Sponsor: Barts & The London NHS Trust (other)
• Drugs / interventions: radiation
• Locations: 1 site (London)
• Trial ID: NCT05696522 on ClinicalTrials.gov

What this trial studies

This clinical trial investigates the safety and efficacy of stereotactic ablative radiotherapy (SABR) for patients suffering from refractory ventricular tachycardia (VT), a serious heart rhythm disorder. The study focuses on individuals who have not responded to conventional treatments, including anti-arrhythmic medications and catheter ablation. Participants will receive SABR, a non-invasive treatment that aims to destroy the abnormal heart tissue causing VT. The trial will assess the impact of this innovative approach on the frequency of VT episodes and overall heart function.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18-85 with recurrent VT that has not responded to standard therapies.

Not a fit: Patients with polymorphic VT, ventricular fibrillation, or those who are inotrope-dependent heart failure will not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could significantly reduce the frequency of VT episodes and improve the quality of life for patients with refractory VT.

How similar studies have performed: While the use of SABR in this context is novel, other studies have explored radiotherapy for cardiac conditions with varying degrees of success.

Eligibility criteria

Inclusion Criteria:

1. They are at least 18-85 years old.
2. They have recurrent VT (at least three episodes in the preceding six months) requiring therapy from an ICD, that is refractory to conventional treatments - both maximally tolerated doses of anti- arrhythmic drugs and/or conventional catheter ablation.
3. They are too frail or do not wish to undergo conventional catheter ablation.
4. They have not had previous radiotherapy to the anticipated treatment field.

Exclusion Criteria:

1. They have polymorphic VT or ventricular fibrillation (VF).
2. They have inotrope-dependent heart failure or a left ventricular assist device (LVAD) in situ.
3. They are unlikely to live more than 12 months irrespective of the VT.
4. There is a potentially reversible cause for the VT e.g. critical coronary artery disease or a metabolic problem such as an overactive thyroid gland.
5. They are unable to provide informed consent.
6. They have had previous radiotherapy to the anticipated treatment field.
7. The patient weighs in excess of 170kg (maximum weight capacity of the tables in the imaging department).

Where this trial is running

London

• St Bartholomew's Hospital — London, United Kingdom (RECRUITING)

Study contacts

• Study coordinator: Hakam Abbas, MSc

Conditions: Radiotherapy, Complications, Ventricular Tachycardia, Structural Heart Abnormality, Heart Failure, radiotherapy, ventricular tachycardia, heart failure