P543Cardiac resynchronization therapy in left ventricular non-compaction: long-term results in a series of 40 patients

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
D A Radu ◽  
C N Iorgulescu ◽  
S N Bogdan ◽  
A I Deaconu ◽  
A Badiul ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Systolic Dysfunction ◽  
Serum Levels ◽  
Left Ventricular ◽  
Long Term Results ◽  
P Value ◽  
P Values ◽  
Mean Differences

Abstract Background Left ventricular non-compaction (LVNC) is a structural cardiomyopathy (SC) with a high probability of LV systolic dysfunction. Left bundle branch block (LBBB) frequently occurs in SCs. Purpose We sought to analyse the evolution of LVNC-CRT (LC) patients in general and compare it with the non-LVNC-CRT group (nLC). Methods We analysed 40 patients with contrast-MRI documented LVNC (concomitant positive Petersen and Jacquier criteria) implanted with CRT devices in CEHB. The follow-up included 7 hospital visits for each patient (between baseline and 3 years). Demographics, risk factors, usual serum levels, pre-procedural planning factors, clinical, ECG, TTE and biochemical markers were recorded. Statistical analysis was performed using software. Notable differences were reported as either p-values from crosstabs (discrete) or mean differences, p-values and confidence intervals from t-tests (continuous). A p-value of .05 was chosen for statistical significance (SS). Results Subjects in LC were younger (-7.52 ys; <.000; (-3.617;-11.440)), with no sex predominance, more obese (45.9 vs. 28.3%; <0.24) and had less ischaemic disease (17.9 vs. 39.7%; <.007). LC implants were usually CRT-Ds (91 vs. 49.5%; <.000) and more frequently MPP-ready (35.8 vs. 8.4%; <.000). At baseline, sinus rhythm was predominant in LC (97.4 vs. 79.8%; <.007) and permitted frequent use of optimal fusion CRT (75.5 vs. 46.6%; <.002). Although initial LVEFs were similar, LCs had much larger EDVs (+48.91 ml; <.020; (+7.705;+90.124)) and ESVs (+34.91; <.05; (+1.657;+71.478)). After an initial encouraging ⁓ 1 year evolution the LC-CRT group crashed its performance in terms of both LVEF and volumes. Thus, at 1 year follow-up, when compared to nLCs, LVEFs were far lower (-22.02%; <.000; (-32.29;-11.76)) while EDVs and ESVs much higher – (+70.8 ml; <.037; (+49.27;+ 189.65)) and (+100.13; <.039; (+5.25;+195)) respectively – in LCs in spite of similarly corrected dyssynchrony. The mean mitral regurgitation (MR) degree at 1 year was much higher in LCs (+1.8 classes; <.002; (+0.69;+2.97)) certainly contributing to the poor results. The cumulated super-responder/responder (SR/R) rates were constantly lower and decreasing at both 1 year (37.5 vs. 72.4; <.040) and 2 years of follow-up (10.1 vs. 80%; NS). Conclusions CRT candidates with LVNC are significantly more severe at the time of implant. After an initial short-term improvement (probably due to acute correction of dyssynchrony) most patients fail to respond in the long term. Severe dilation with important secondary MR probably plays an important role.

P1171Optimal fusion vs. biventricular pacing in cardiac resynchronization therapy: long-term results of 540 consecutive patients

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
D A Radu ◽  
C N Iorgulescu ◽  
S N Bogdan ◽  
A I Deaconu ◽  
A Nastasa ◽  
...  
Keyword(s):  
Biventricular Pacing ◽  
Statistical Significance ◽  
Left Ventricular ◽  
Long Term Results ◽  
Cardiac Resynchronization ◽  
P Value ◽  
Data Set ◽  
P Values

Abstract Background Right ventricular (RV) stimulation induces supplemental dyssynchrony in case of left bundle branch block (LBBB) patients. Isolated left ventricular (LV) pacing has been proven superior to biventricular pacing (BiV) in terms of acute hemodynamic response. Purpose We sought to determine whether an optimised isolated LV pacing algorithm called "optimal fusion" (OFu) produces better and sustainable effects when compared to BiV in the long term. Methods 540/760 (reasonable data collection) consecutive patients implanted with CRT in CEHB were analysed. The follow-up included 7 hospital visits for each patient (between baseline and 3 years). Demographics, risk factors, usual serum levels, pre-procedural planning factors, clinical, ECG, TTE and biochemical markers were recorded. Statistical analysis was performed using software. Data were reported as either p-values from crosstabs (discrete) or mean differences, p-values and confidence intervals from t-tests (continuous). A p-value of .05 was chosen for statistical significance (SS). Results The overall group consisted of 51% OFu (275) and the rest BiV patients. Subjects in OFu were younger (-4.379 ys; <.001; (-7.028;-1.729)), more often females (40.9 vs. 24.9%; <.002), more obese (40.1 vs. 29.6%; <0.40) and had more structural disease other than ischaemic scar burden (10.8 vs. 2.7%; <.005). Procedures in OFu were mainly "de novo" (93 vs. 73.4%; <.000), more often CRT-Ds (58.2 vs. 42.9%; <.005) and more frequently in sinus rhythm (99.4 vs. 62.3%; <.000) and with typical LBBB (77.2 vs. 45%; <.000). Baseline PR interval was shorter in OFu (-32.20 msec; <.033; (-61.58;-2.58)). Notably, OFu patients started from a lower EF (-3.29%; <.001; (-5.156;-1.441)), had more dyssynchrony as evaluated by Pitzalis’ index (34.32 msec; <.017; (6.132;62.522)) and poorer initial mechanical performance by dP/dt (-104.83 mm Hg/sec; <.012; (-185.301;-24.366)). There was no SS difference in clinical parameters at 3 years. Mean EF was higher in OFu (38.59 vs. 34.82%; NS; (4.183;-4.755)) while both EDVs (170.40 vs. 161.40 ml; NS; (-82.40;100.40)) and ESVs (115.36 vs. 102.67 ml; NS; (-82.65;108.03)) were lower. When looking at absolute Δs, OFu performed much better in the long term: EF (+15.81 vs. +8.86%; NS; (-17.06877;3.17710)), EDV (-46.07 vs. – 10.1 ml; NS; (-19.88;102.60)) and ESV (-55.91 vs. -17.46 ml; NS; (-39.88;124.71)). The cumulated super-responder/responder (SR/R) percentage at 1 year was much higher in OFu (83.43 vs. 57.75; <.040). Conclusions The benefit of OFu is definitely sustainable in the long term. Structural response is constantly superior with OFu when compared to BiV although the current data set did not yield SS when comparing absolute means. However, parameter Δs are clearly in favor of OFu which produced a SS higher cumulated rate of SR/Rs over 3 years of follow-up.

scholarly journals Long-term results of endonasal dacryocystorhinostomy with and without stenting

2013 ◽  
Vol 95 (3) ◽  
pp. 196-199 ◽  
Author(s):  
SH Mohamad ◽  
I Khan ◽  
M Shakeel ◽  
V Nandapalan
Keyword(s):  
Success Rate ◽  
Statistical Significance ◽  
Case Series ◽  
Senior Author ◽  
Long Term Results ◽  
P Value ◽  
Stent Group ◽  
Chi Squared

Introduction This study aimed to evaluate the short and long-term results of endoscopic dacryocystorhinostomy (DCR) with and without silicone stenting in chronic dacrocystorhinitis due to postsaccal blockage. Methods The study involved a case series of consecutive 89 patients (128 eyes) who underwent endoscopic DCR. All patients were operated on by the senior author. The stent group comprised 63 eyes (44 patients), for which the DCR was performed between September 2002 and September 2005. The non-stent group with 65 eyes (45 patients) underwent the DCR between October 2005 and December 2006. The follow-up duration was up to 33 months after surgery. The statistical significance (p-value) was calculated using the chi-squared test. Results The short-term success rate at six months’ follow-up was 70% in the stent group and 97% in the non-stent group (p=0.0005) while the long-term success rate at 33 months was only 57% in stent group compared with 89% in the non-stent group (p=0.0003). Conclusions In this study, the non-stent group showed a higher success rate than the stent group on both short and longterm follow-up. Our study suggests that postoperative stents are not necessary for primary DCR and may be associated with a worse outcome.

Long-term results of thoracoscopic ablation of paroxysmal atrial fibrillation: is the glass half full or half empty?

2021 ◽  
Author(s):  
Igor Belluschi ◽  
Elisabetta Lapenna ◽  
Davide Carino ◽  
Cinzia Trumello ◽  
Manuela Cireddu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Confidence Interval ◽  
Paroxysmal Atrial Fibrillation ◽  
Left Ventricular ◽  
Class I ◽  
Long Term Results ◽  
Left Ventricular Ejection ◽  
Af Recurrence

Abstract OBJECTIVES Previous series showed the outcomes of thoracoscopic ablation of stand-alone symptomatic paroxysmal atrial fibrillation (AF) for up to 7 years of follow-up. The goal of this study was to assess the long-term durability of surgical pulmonary vein isolation (PVI) beyond 7 years. METHODS Fifty consecutive patients {mean age 55 [standard deviation (SD): 11.2] years, previous catheter ablation in 56%, left ventricular ejection fraction 60% (SD: 4.6), left atrium volume 65 ml (SD: 17)} with stand-alone symptomatic paroxysmal AF underwent PVI through bilateral thoracoscopy ablation between 2005 and 2014. The CHA2DS2-VASc score was ≥2 in 12 patients (24%). RESULTS No hospital deaths occurred. At hospital discharge all patients but 1 (2%) were in sinus rhythm (SR). Follow-up was 100% complete [mean 8.4 years (SD: 2.3), max 15]. The 8-year cumulative incidence function of AF recurrence, with death as a competing risk, on or off class I/III antiarrhythmic drugs (AADs)/electrocardioversion/re-transcatheter ablation (TCA) was 20% (SD: 5; 95% confidence interval: 10, 32); and off class I/III AADs/electrocardioversion/re-TCA was 52% (SD: 7; 95% confidence interval: 0.83, 8.02). At 8 years, the predicted prevalence of patients in SR was 87% and 53% were off class I/III AADs/electrocardioversion/re-TCA. The recurrent arrhythmia was AF in all patients except 2, who had atypical atrial flutter (4%). No predictors of AF recurrence were identified. At the last follow-up, 76% of the patients showed European Heart Rhythm Association class I. No strokes or thromboembolic events were documented and 76% of the subjects were off anticoagulation therapy. CONCLUSIONS Despite a considerable AF recurrence rate, our single-centre, long-term outcome of surgical PVI showed encouraging data, with the majority of patients remaining in SR, although many of them were on antiarrhythmic therapy.

Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein?

2018 ◽  
Vol 33 (9) ◽  
pp. 646-652 ◽  
Author(s):  
Orsini Camillo
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Statistical Significance ◽  
Long Term Results ◽  
Complication Rates ◽  
Foam Sclerotherapy ◽  
Occlusion Rate ◽  
Long Term Experience

Objective This retrospective study presents the long-term results of catheter-directed foam sclerotherapy of the great saphenous vein. Method From January 2003 to June 2017, 277 patients with varices and great saphenous vein incompetence were treated with echo-guided foam sclerotherapy. Forty-six patients were treated with long-catheters guided by foam sclerotherapy. Foaming was carried out with sodium-tetra-decyl-sulphate. Results Results were examined in the two groups: A (long-catheters) and B (other procedures). The median overall follow-up was 52.1 months. In the A-group, the complete occlusion rate was 34/46 pts (73.9%) and partial occlusion was 10/46 (21.7%). In the B-group, respectively, 130/231 (56.2%) and 90/231 (38.9%). Comparisons between groups were statistically significant (p = 0.023; p = 0.021). Failures involved, respectively, 2/46 (4.3%) and 11/231 (4.7%) with no statistical significance. The complication rates were similar in the two groups. Conclusions In this long-term experience (median follow-up exceeding four years), foam-guided sclerotherapy of the great saphenous vein with a long-catheter turned out to be more effective than the usual foam-guided sclerotherapy.

P1868Risk of arrhythmias after myocardial infarction in patients with left ventricular systolic dysfunction according to mode of revascularization: a CARISMA substudy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Thomsen ◽  
S Pedersen ◽  
P K Jacobsen ◽  
H V Huikuri ◽  
P E Bloch Thomsen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Loop Recorder ◽  
Ventricular Ejection Fraction ◽  
New Onset

Abstract Introduction The CARISMA trial was the first study to use continuous monitoring for documentation of long-term arrhythmias in post-infarction patients with left ventricular dysfunction. During the study duration (2000–2005), primary PCI (pPCI) as treatment of acute myocardial infarction was introduced approximately midway (2002) on the enrolling centres. Purpose The aim of this study was to describe the influence of mode of revascularization after myocardial infarction (AMI) on long-term risk of risk of new onset atrial fibrillation, ventricular tachyarrhythmias and brady arrhythmias. Methods The study is a sub-study on the CARISMA study population that consisted of patients with AMI and left ventricular ejection fraction ≤40%, which received an implantable loop recorder and was followed for 2 years. After exclusion of 15 patients who refused device implantation and 26 with pre-existing arrhythmias, 268 of the 312 patients were included. Choice of revascularization was made by the treating team independently of the trial and was retrospectively divided into primary percutaneous intervention (pPCI), subacute PCI (24 hours to 2 weeks after AMI), primary thrombolysis or no revascularization. Endpoints were new-onset of arrhythmias and major cardiovascular events (MACE). The Kaplan-Meier (figure 1) and Mantel-Byar methods were used for time to first event risk analysis. Results A total of 77 patients received no revascularization, whereas 49 received thrombolysis only and 142 received PCI. At two-years follow up patients treated with any PCI had a significant lower risk (0.40, n=63) of any arrhythmia compared to patients treated with trombolysis (0.60, n=30) or no revascularization (0.68, n=16) (p<0.001, unadjusted) (figure 1). Risk of MACE was significant higher in patients with any arrhythmia (0.25, n=76) compared to no arrhythmia (0.11, n=93) at two years follow-up (p=0.004, unadjusted). Figure 1 Conclusion(s) The long-term risk of new onset arrhythmias after AMI was significantly lower in patients treated with any PCI compared to patients not revascularized or treated with thrombolysis. Risk of MACE was significantly higher in patients with new onset arrhythmias compared to patients with no arrhythmias.

scholarly journals Enhanced Inflammation is a Marker for Risk of Post-Infarct Ventricular Dysfunction and Heart Failure

2020 ◽  
Vol 21 (3) ◽  
pp. 807 ◽  
Author(s):  
Iwona Świątkiewicz ◽  
Przemysław Magielski ◽  
Jacek Kubica ◽  
Adena Zadourian ◽  
Anthony N. DeMaria ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Multivariable Analysis ◽  
High Sensitivity ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Reactive Protein

Acute ST-segment elevation myocardial infarction (STEMI) activates inflammation that can contribute to left ventricular systolic dysfunction (LVSD) and heart failure (HF). The objective of this study was to examine whether high-sensitivity C-reactive protein (CRP) concentration is predictive of long-term post-infarct LVSD and HF. In 204 patients with a first STEMI, CRP was measured at hospital admission, 24 h (CRP24), discharge (CRPDC), and 1 month after discharge (CRP1M). LVSD at 6 months after discharge (LVSD6M) and hospitalization for HF in long-term multi-year follow-up were prospectively evaluated. LVSD6M occurred in 17.6% of patients. HF hospitalization within a median follow-up of 5.6 years occurred in 45.7% of patients with LVSD6M vs. 4.9% without LVSD6M (p < 0.0001). Compared to patients without LVSD6M, the patients with LVSD6M had higher CRP24 and CRPDC and persistent CRP1M ≥ 2 mg/L. CRP levels were also higher in patients in whom LVSD persisted at 6 months (51% of all patients who had LVSD at discharge upon index STEMI) vs. patients in whom LVSD resolved. In multivariable analysis, CRP24 ≥ 19.67 mg/L improved the prediction of LVSD6M with an increased odds ratio of 1.47 (p < 0.01). Patients with LVSD6M who developed HF had the highest CRP during index STEMI. Elevated CRP concentration during STEMI can serve as a synergistic marker for risk of long-term LVSD and HF.

scholarly journals Long-Term Postoperative Total Knee Arthroplasty Flexion Scores in Relation to Body Mass Index

2020 ◽  
Author(s):  
Matthew A. Siegel ◽  
Michael J. Patetta ◽  
Angie M. Fuentes ◽  
Armaan S. Haleem ◽  
Craig W. Forsthoefel ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Statistical Significance ◽  
P Value ◽  
Preoperative Body Mass Index ◽  
Total Knee

AbstractKnee range of motion (ROM) is an important postoperative measure of total knee arthroplasty (TKA). There is conflicting literature whether patients who are obese have worse absolute ROM outcomes than patients who are not obese. This study analyzed whether preoperative body mass index (BMI) influences knee ROM after patients' primary TKA. A retrospective investigation was performed on patients, who underwent primary TKA at an academic institution, by one of three fellowship-trained adult reconstruction surgeons. Patients were stratified according to their preoperative BMI into nonobese (BMI < 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2) classifications. Passive ROM was assessed preoperatively as well as postoperatively at patients' most recent follow-up visit that was greater than 2 years. Mann–Whitney U tests were performed to determine statistical significance at p-value <0.05 for ROM outcomes. No statistically significant differences were observed when ROM in the nonobese group was compared with ROM in the obese group both preoperatively (105.73 ± 11.58 vs. 104.14 ± 13.58 degrees, p-value = 0.417) and postoperatively (105.83 ± 14.19 vs. 104.49 ± 13.52 degrees, p-value = 0.777). Mean follow-up time for all patients was 4.49 ± 1.92 years. In conclusion, long-term postoperative ROM outcomes were similar between patients who were nonobese and patients who were obese.

P6263Results of percutaneous coronary intervention of unprotected left main coronary disease in octogenarian patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M J Romero Reyes ◽  
A Moya Martin ◽  
N Gonzalez Alemany ◽  
F J Sanchez Burguillos ◽  
P Perez Santigosa ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Mortality Rate ◽  
Coronary Disease ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Long Term Results ◽  
Left Main ◽  
Percutaneous Coronary

Abstract Introduction Conservative treatment unprotected left main coronary (uLMCA) disease has a high mortality rate (50% at 3 years). Since octogenarian patients are often dismissed for surgical treatment, they tend to adopt a more conservative attitude in this population. Purpose We report medium and long-term outcomes of percutaneous coronary intervention (PCI) for uLCMA stenosis in elderly patients. Methods Retrospective cohort study of consecutive patients ≥80 years with uLMCA stenosis, treated with PCI at a single center between June 2005 and February 2017. Results A total of 100 patients were included in the study. 58% were male, with a mean age of 83.8±3 years. There were 86% hypertensive, 63% diabetic and 68% dyslipidemic. 14% of the patients had an LVEF ≤35%. Unstable angina (45%) and acute coronary syndromes withouth ST-segment elevation (44%) were the most common presentation. In 9% of the cases, cardiogenic shock was the initial presentation form. The distal left main coronary was the most frequent localitation of the lesion (46%) followed by the ostium (33%). In 63% of the cases, a multivessel coronary disease was detected and in 47% the revascularization was incomplete. The survival rate after a year follow up was 79% and after three years follow up was 65%. However, in most of the cases the cause of death was due to other comorbidities, with cardiac death being 10% per year and 13% at 3 years of follow-up. The rate of non-fatal acute myocardial infarction was 13% per year, increasing to 20% at 3 years of follow-up. There was a 9% stent restenosis implanted at 3 years. The presence of severe left ventricular systolic dysfunction was the main predictor of mortality in long-term follow-up (OR 1.39 [95% CI 1.10–1.752], p<0.001). Incomplete revascularization was not associated with a higher mortality rate. Conclusion PCI is a safety option for revascularization in uLMCA stenosis in elderly patientes with excellent short-term results, as well as acceptable long-term results. Age should not be a handicap to consider uLMCA revascularization in this population.

scholarly journals Nonparallel Progression of Left Ventricular Structure and Function in Long-Term Peritoneal Dialysis Patients

2017 ◽  
Vol 7 (3) ◽  
pp. 198-206 ◽  
Author(s):  
Qiuhong Shi ◽  
Jing Zhu ◽  
Sheng Feng ◽  
Huaying Shen ◽  
Jianchang Chen ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Left Atrial ◽  
Antihypertensive Drugs ◽  
Statistical Significance ◽  
Left Ventricular ◽  
Structure And Function ◽  
Left Atrial Diameter ◽  
And Function

Background/Aims: Left ventricular hypertrophy and dysfunction are key cardiovascular risk factors of patients on peritoneal dialysis (PD). The purpose of this study was to investigate the dynamic changes of left ventricular (LV) structure and function in patients on long-term PD. Methods: Patients who underwent PD catheter insertions from January 2010 to December 2012 in our PD center were enrolled into this study. Cardiac structure and function of those patients were determined by echocardiography (4 times) at 12-month intervals. Patients' biochemical parameters, body mass index, blood pressure, urine output, ultrafiltration, and total fluid removal volume were collected. The use of antihypertensive drugs and active vitamin D3 was also recorded. Results: A total of 40 patients were included. After 3 years of follow-up, patients' PD duration time, LV mass/height2.7 (p = 0.580), interventricular septal thickness (p = 0.216), left ventricular posterior wall thickness (p = 0.216), and LV ejection fraction (p = 0.270) did not show significant changes during the follow-up. In contrast, the E/A ratio (p = 0.004) and e' (p < 0.001) were statistically decreased, and the E/e' ratio (p = 0.006) was increased. Left atrial diameter was increased (p = 0.008), but the changes in left atrial diameter index did not reach statistical significance (p = 0.090). Conclusion: Long-term PD patients maintain stable LV structure and cardiac systolic function, but cardiac diastolic function declines over time.

scholarly journals Stereotactic arrhythmia radioablation for refractory scar-related ventricular tachycardia

2019 ◽  
Author(s):  
Carola Gianni ◽  
Douglas Rivera ◽  
J David Burkhardt ◽  
Brad Pollard ◽  
Edward Gardner ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Stereotactic Radiosurgery ◽  
Left Ventricular ◽  
The Body ◽  
Long Term Results ◽  
Radiotherapy Planning ◽  
Left Ventricular Ejection

AbstractBackgroundStereotactic radiosurgery is a form of radiotherapy that is performed in a single session and focuses high-dose ionizing radiation beams from a collimated radiation source to a small, localized area of the body. Recently, stereotactic radiosurgery has been applied to arrhythmias (stereotactic arrhythmia radioablation - STAR), with promising results reported in patients with refractory, scar-related ventricular tachycardia (VT), a cohort with known high morbidity and mortality.ObjectiveHerein, we describe our experience with the use of CyberKnife, a frameless image-guided linear accelerator stereotactic radiosurgery system, in conjunction with CardioPlan, a cardiac specific radiotherapy planning software, to treat patients with scar-related VT, detailing its early and mid-to long-term results.MethodsThis is a pilot, prospective study of patients undergoing STAR for refractory VT. The anatomical target for radioablation was defined based on the clinical VT morphology, electroanatomical mapping, and study-specific pre-procedural imaging with cardiac computed tomography. The target volume delineated with the aid of CardioPlan was treated with a prescription radiation dose of 25 Gy delivered in a single fraction by CyberKnife in an outpatient setting. Ventricular arrhythmias and radiation-related adverse events were monitored at follow-up to determine STAR efficacy and safety.ResultsFive patients (100 % male, 63 ± 12 years old, 80 % ischemic cardiomyopathy, left ventricular ejection fraction 34 ± 15 %) with refractory VT underwent STAR between January and June 2018. Radioablation was delivered in 82 ± 11 minutes without acute complications. During a mean follow-up of 12 ± 2 months, all patients experienced clinically significant mid-to late-term ventricular arrhythmia recurrence; two patients died of complications associated with their advanced heart failure. There were no clinical or imaging evidence of radiation necrosis or other radiation-induced complications in the organs at risk surrounding the scar targeted by radioablation.ConclusionDespite good initial results, STAR did not result in effective ventricular arrhythmia control in the long term in a selected, high-risk population of patients with scar-related VT. The safety profile was confirmed to be favorable, with no radiation-related complications observed during follow-up. Further studies are needed to explain these disappointing results.

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