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Miszczyk M, Sajdok M, Bednarek J, Latusek T, Wojakowski W, Tomasik B, Wita K, Jadczyk T, Kurzelowski R, Drzewiecka A, Cybulska M, Gardas R, Jarosiński G, Dolla Ł, Grządziel A, Zub K, Bekman A, Kaminiów K, Kozub A, Gołba KS, Blamek S. Stereotactic management of arrhythmia - radiosurgery in treatment of ventricular tachycardia (SMART-VT). Results of a prospective safety trial. Radiother Oncol 2023; 188:109857. [PMID: 37597807 DOI: 10.1016/j.radonc.2023.109857] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/25/2023] [Accepted: 08/09/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND AND PURPOSE Despite its increasing popularity, there are limited prospective data on stereotactic arrhythmia radioablation (STAR). In this trial, we assessed the safety and efficacy of STAR in patients with ventricular tachycardia (VT), focusing on early treatment-related grade ≥ 3 adverse events (AE). MATERIALS AND METHODS This prospective trial was designed for adults with VT recurrence following catheter ablation (CA) despite adequate pharmacotherapy, or contraindications to CA. A single dose of 25 Gy was delivered to the arrhythmia substrate defined on electro-anatomic mapping and cardiac-gated CT. The primary endpoint was safety, defined as two or fewer treatment-related grade ≥ 3 AEs during the first three months in 11 patients. Additional endpoints included treatment efficacy, clinical and biological markers of cardiac injury, and quality of life. RESULTS Eleven patients with a median age of 67 years, structural heart disease, and a clinically significant recurrence of VT despite adequate pharmacotherapy and 1-4 previous CAs were enrolled between 2020/09 and 2022/10. Following the treatment, one patient developed a possibly treatment-related grade ≥ 3 AE, a grade 4 heart failure exacerbation at 87 days, which resolved after conservative treatment. There was a total 84.3% reduction in VT burden in 10 evaluable patients; however, VT recurrence was eventually observed in eight, and three patients required additional CAs. Three deaths due to unrelated causes were recorded. CONCLUSIONS STAR appears to be safe and efficient. It is a promising treatment for selected patients; however, long-term outcomes remain to be evaluated, and controlled trials comparing STAR with standards of care are missing.
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Affiliation(s)
- Marcin Miszczyk
- III(rd) Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland.
| | - Mateusz Sajdok
- Department of Electrocardiology, Upper-Silesian Heart Center, 7th Medical University of Silesia Hospital, Ziołowa 45/47 40-635, Katowice, Poland
| | - Jacek Bednarek
- Department of Electrocardiology and Heart Failure, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Ziołowa 45/47 40-635, Katowice, Poland; Department of Cardiology and Structural Heart Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Ziołowa 45/47 40-635, Katowice, Poland; Department of Electrocardiology, John Paul II Hospital, Prądnicka 80 31-202, Kraków, Poland
| | - Tomasz Latusek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Ziołowa 45/47 40-635, Katowice, Poland
| | - Bartłomiej Tomasik
- Department of Oncology and Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, Mariana Smoluchowskiego 17 80-214, Gdańsk, Poland
| | - Krystian Wita
- I(st) Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Ziołowa 47 40-635, Katowice, Poland
| | - Tomasz Jadczyk
- Department of Cardiology and Structural Heart Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Ziołowa 45/47 40-635, Katowice, Poland; Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne's University Hospital, Pekařská 53 602 00, Brno, Czechia
| | - Radosław Kurzelowski
- Department of Cardiology and Structural Heart Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Ziołowa 45/47 40-635, Katowice, Poland
| | - Anna Drzewiecka
- Department of Electrocardiology, Upper-Silesian Heart Center, 7th Medical University of Silesia Hospital, Ziołowa 45/47 40-635, Katowice, Poland
| | - Magdalena Cybulska
- Department of Electrocardiology, Upper-Silesian Heart Center, 7th Medical University of Silesia Hospital, Ziołowa 45/47 40-635, Katowice, Poland; Department of Electrocardiology and Heart Failure, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Ziołowa 45/47 40-635, Katowice, Poland; CT and MRI Department, Voxel S.A, Radiowa 2 44-100, Gliwice, Poland
| | - Rafał Gardas
- Department of Electrocardiology, Upper-Silesian Heart Center, 7th Medical University of Silesia Hospital, Ziołowa 45/47 40-635, Katowice, Poland; Department of Electrocardiology and Heart Failure, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Ziołowa 45/47 40-635, Katowice, Poland
| | - Grzegorz Jarosiński
- Department of Electrocardiology, Upper-Silesian Heart Center, 7th Medical University of Silesia Hospital, Ziołowa 45/47 40-635, Katowice, Poland
| | - Łukasz Dolla
- Radiotherapy Planning Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
| | - Aleksandra Grządziel
- Radiotherapy Planning Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
| | - Kamil Zub
- Department of Electrocardiology, Upper-Silesian Heart Center, 7th Medical University of Silesia Hospital, Ziołowa 45/47 40-635, Katowice, Poland
| | - Adam Bekman
- Department of Medical Physics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
| | - Konrad Kaminiów
- III(rd) Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
| | - Anna Kozub
- III(rd) Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
| | - Krzysztof S Gołba
- III(rd) Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland; Department of Electrocardiology and Heart Failure, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Ziołowa 45/47 40-635, Katowice, Poland
| | - Sławomir Blamek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice branch, Wybrzeże Armii Krajowej 15 44-102, Gliwice, Poland
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Wejner-Mik P, Sajdok M, Trzos E, Lipiec P, Kasprzak JD. Yet another explanation for Pheidippides' death? Kardiol Pol 2023; 81:784-785. [PMID: 37128930 DOI: 10.33963/kp.a2023.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Paulina Wejner-Mik
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland.
| | - Mateusz Sajdok
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - Ewa Trzos
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - Piotr Lipiec
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - Jarosław D Kasprzak
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
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Sajdok M, Kawa M, Miszczyk M, Błach A, Chrabański O, Soral T, Śmietana A, Stadnik D, Musik P, Biernat J, Deja M, Gołba KS. Melanoma metastasis of the heart: Case report of an atypical metastatic location. Kardiol Pol 2023; 81:1290-1292. [PMID: 38189510 DOI: 10.33963/v.kp.97945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Mateusz Sajdok
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland.
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.
| | - Michał Kawa
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Marcin Miszczyk
- 3rd Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Anna Błach
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Department of Nuclear Medicine, Voxel Diagnostic Center, Katowice, Poland
| | - Olgierd Chrabański
- Department of Nuclear Medicine, Voxel Diagnostic Center, Katowice, Poland
- Department of Radiodiagnostics, Interventional Radiology and Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Nuclear Medicine and Endocrine Oncology, Maria Skodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Tomasz Soral
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Adam Śmietana
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Daniel Stadnik
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Pneumonology, Upper Silesian Medical Center, Medical University of Silesia, Katowice, Poland
| | - Paulina Musik
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Jolanta Biernat
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Marek Deja
- Department of Cardiac Surgery, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Krzysztof S Gołba
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
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4
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Gardas R, Golba KS, Loboda D, Biernat J, Soral T, Kulesza P, Sajdok M, Zub K. The usefulness of His bundle pacing in a heterogeneous population of patients with impaired left ventricular systolic function. Cardiol J 2022:VM/OJS/J/90497. [PMID: 35997047 DOI: 10.5603/cj.a2022.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/06/2022] [Accepted: 08/07/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND His bundle pacing (HBP) maintains a physiological activation pattern of ventricular activation, and in patients with intraventricular conduction delay (IVCD) it can normalize wide QRS duration. METHODS A total of 181 patients from the HBP registry were enrolled into a the study, which was conducted at the Department of Electrocardiology in Katowice, Poland. The patients had left ventricular ejection fraction (LVEF) < 50% and were implanted between November 2015 and April 2019. The HBP indications were as follows: 1) bradycardia and atrioventricular conduction disturbances with expected high pacing burden, 2) IVCD, LVEF ≤ 35%, with an indication for resynchronization therapy, 3) the need to upgrade to resynchronization therapy due to pacing-induced cardiomyopathy. Pacing parameters and echocardiographic and clinical data were assessed for up to 2 years of follow-up (FU). RESULTS His bundle pacing was successful in 154 (85.1%) patients. Eighty-two patients completed a 6-month FU. The mean age was 70.6 ± 9.23 years, and 79% were males. At 6 months FU LVEF improved from 35.3 ± 8.22% to 43.1 ± 10.14% (p < 0.0001), and indexed left ventricular end-systolic volume (LVESVi) decreased from 63.1 ± 25.21 mL/m² to 51.9 ± 22.79 mL/m² (p < 0.0001). In 53.1%, the LVESVi reduction was greater than 15%. The improvement in LVEF and LVESVi was also observed after 24 months of FU. CONCLUSIONS His bundle pacing in permanently paced patients when LVEF is reduced below 50% is associated with improvement in LVEF and reverse left ventricle remodeling.
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Affiliation(s)
- Rafal Gardas
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.
- Department of Electrocardiology, Leszek Giec Upper-Silesian Medical Center of the Silesian Medical University, Katowice, Poland.
| | - Krzysztof S Golba
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, Leszek Giec Upper-Silesian Medical Center of the Silesian Medical University, Katowice, Poland
| | - Danuta Loboda
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, Leszek Giec Upper-Silesian Medical Center of the Silesian Medical University, Katowice, Poland
| | - Jolanta Biernat
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Tomasz Soral
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Piotr Kulesza
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Mateusz Sajdok
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Kamil Zub
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
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Miszczyk M, Sajdok M, Nożyński J, Cybulska M, Bednarek J, Jadczyk T, Latusek T, Kurzelowski R, Dolla Ł, Wojakowski W, Dyla A, Zembala M, Drzewiecka A, Kaminiów K, Kozub A, Chmielik E, Grza̧dziel A, Bekman A, Gołba KS, Blamek S. Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation). Front Cardiovasc Med 2022; 9:919823. [PMID: 35872906 PMCID: PMC9302025 DOI: 10.3389/fcvm.2022.919823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Cardiac stereotactic body radiotherapy is an emerging treatment method for recurrent ventricular tachycardia refractory to invasive treatment methods. The single-fraction delivery of 25 Gy was assumed to produce fibrosis, similar to a post-radiofrequency ablation scar. However, the dynamics of clinical response and recent preclinical findings suggest a possible different mechanism. The data on histopathological presentation of post-radiotherapy hearts is scarce, and the authors provide significantly different conclusions. In this article, we present unique data on histopathological examination of a heart explanted from a patient who had a persistent anti-arrhythmic response that lasted almost a year, until a heart failure exacerbation caused a necessity of a heart transplant. Despite a complete treatment response, there was no homogenous transmural fibrosis in the irradiated region, and the overall presentation of the heart was similar to other transplanted hearts of patients with advanced heart failure. In conclusion, our findings support the theorem of functional changes as a source of the anti-arrhythmic mechanism of radiotherapy and show that durable treatment response can be achieved in absence of transmural fibrosis of the irradiated myocardium.
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Affiliation(s)
- Marcin Miszczyk
- IIIrd Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
- *Correspondence: Marcin Miszczyk, , orcid.org/0000-0002-4375-0827
| | - Mateusz Sajdok
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Jerzy Nożyński
- Department of Histopathology, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Magdalena Cybulska
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Jacek Bednarek
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, John Paul II Hospital, Kraków, Poland
| | - Tomasz Jadczyk
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
| | - Tomasz Latusek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Radoslaw Kurzelowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Łukasz Dolla
- Radiotherapy Planning Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Dyla
- Department of Cardiac Surgery, Heart and Lung Transplantation, Mechanical Circulatory Support, Silesian Centre for Heart Diseases, Zabrze, Poland
- Anaesthesiology and Intensive Care Unit, District Hospital in Oława, Oława, Poland
| | - Michał Zembala
- Department of Cardiac Surgery and Transplantology, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Anna Drzewiecka
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Konrad Kaminiów
- IIIrd Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Anna Kozub
- IIIrd Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Aleksandra Grza̧dziel
- Radiotherapy Planning Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Adam Bekman
- Department of Medical Physics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Krzysztof Stanisław Gołba
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Sławomir Blamek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
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Miszczyk M, Sajdok M, Jadczyk T, Kurzelowski R, Latusek T, Gołba K, Bednarek J, Dolla Ł, Grządziel A, Zub K, Tomasik B, Cybulska M, Gardas R, Drzewiecka A, Wojakowski W, Wita K, Blamek S. PO-1057 Interim analysis of a prospective ventricular tachycardia radioablation safety trial (NCT04642963). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03021-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kurzelowski R, Latusek T, Miszczyk M, Jadczyk T, Bednarek J, Sajdok M, Gołba KS, Wojakowski W, Wita K, Gardas R, Dolla Ł, Bekman A, Grza̧dziel A, Blamek S. Radiosurgery in Treatment of Ventricular Tachycardia – Initial Experience Within the Polish SMART-VT Trial. Front Cardiovasc Med 2022; 9:874661. [PMID: 35509272 PMCID: PMC9058092 DOI: 10.3389/fcvm.2022.874661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundStereotactic Arrhythmia Radioablation (STAR) is an emerging treatment modality for patients with sustained ventricular tachycardia (VT) and refractory to treatment with drugs and radiofrequency catheter ablation (RFA). It is believed that up to 12–17% of patients experience recurrence of VT within 1 year of follow-up; thus, novel therapeutic options are needed. The aim of this article is to present initial experience within a novel treatment modality for VT.Case SummaryTwo patients with a medical history of coronary artery disease and heart failure with reduced left ventricle (LV) ejection fraction, after implantation of cardioverter-defibrillator (ICD) and previous unsuccessful RFAs owing to sustained VT were admitted to the cardiology department due to recurrence of sustained VT episodes. With electroanatomical mapping (EAM), the VT substrate in LV has been confirmed and specified. In order to determine the target volume for radioablation, contrast-enhanced computed tomography was performed and the arrhythmia substrate was contoured using EAM data. Using the Volumetric Modulated Arc Therapy technique and three 6 MeV flattening filter-free photon beam fields, a single dose of 25 Gy was delivered to the target volume structure located in the apex and anterior apical segments of LV in the first patient and in the apex, anterolateral and inferior apical segments of the second patient. In both cases, volumes of the target structures were comparable. Interrogation of the implanted ICD at follow-up visits throughout 6 months after the treatment revealed no VT episodes in the first patient and sudden periprocedural increase in VT burden with a subsequent gradual decrease of ventricular arrhythmia to only two non-sustained episodes at the end of the follow-up period in case of the second patient. A significant reduction in premature ventricular contractions burden was observed compared to the pre-treatment period. No noticeable deterioration in LV function was noted, nor any adverse effects of radiosurgery associated with the implanted device.ConclusionThe early response to STAR can be unpredictable and probably does not reflect the final outcome of irradiation. Close monitoring of patients, especially in the early period after irradiation is crucial to properly handle potentially harmful early reactions to STAR.
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Affiliation(s)
- Radosław Kurzelowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- *Correspondence: Radosław Kurzelowski,
| | - Tomasz Latusek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Marcin Miszczyk
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Tomasz Jadczyk
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, Brno, Czechia
| | - Jacek Bednarek
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, Prof. Leszek Giec Upper-Silesian Medical Centre of the Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, John Paul II Hospital, Kraków, Poland
| | - Mateusz Sajdok
- Department of Electrocardiology, Prof. Leszek Giec Upper-Silesian Medical Centre of the Medical University of Silesia, Katowice, Poland
| | - Krzysztof S. Gołba
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, Prof. Leszek Giec Upper-Silesian Medical Centre of the Medical University of Silesia, Katowice, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Krystian Wita
- First Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Rafał Gardas
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology, Prof. Leszek Giec Upper-Silesian Medical Centre of the Medical University of Silesia, Katowice, Poland
| | - Łukasz Dolla
- Department of Radiotherapy Planning, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Adam Bekman
- Department of Medical Physics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Aleksandra Grza̧dziel
- Department of Radiotherapy Planning, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Sławomir Blamek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
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8
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Cybulska M, Sajdok M, Bednarek J, Miszczyk M, Jadczyk T, Kurzelowski R, Gardas R, Drzewiecka A, Jarosiński G, Zub K, Latusek T, Wojakowski W, Blamek S, Gołba K. Stereotactic arrhythmia radioablation in recurrent ventricular tachyarrhythmias. Kardiol Pol 2022; 80:367-369. [PMID: 35076080 DOI: 10.33963/kp.a2022.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Magdalena Cybulska
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland. .,Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.
| | - Mateusz Sajdok
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Jacek Bednarek
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.,Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.,Department of Electrocardiology, John Paul II Hospital, Kraków, Poland
| | - Marcin Miszczyk
- 3rd Department of Radiotherapy and Chemotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Tomasz Jadczyk
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.,Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Radosław Kurzelowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Rafał Gardas
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland.,Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Anna Drzewiecka
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Jarosiński
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Kamil Zub
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Tomasz Latusek
- 3rd Department of Radiotherapy and Chemotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Sławomir Blamek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Krzysztof Gołba
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland.,Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
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Wajdlich MJ, Podlejska P, Rosół D, Maciejewski M, Kolejwa M, Wynimko M, Sajdok M, Nowicki M. Wpływ stopnia nawodnienia oraz zmienności ciśnienia tętniczego krwi i częstości rytmu serca w czasie hemodializy na śróddializacyjne zmiany stężeń wysokoczułej troponiny T. Arterial Hypertension 2017. [DOI: 10.5603/ah.a2017.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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