For patients suffering from severe and uncontrollable heart rhythm problems, a new study brings promising news.
Radiation therapy, usually used to treat cancer, may offer a safer and equally effective option compared to the current standard treatment—catheter ablation.
This new research, presented at the ASTRO Annual Meeting in San Francisco and published in the International Journal of Radiation Oncology • Biology • Physics, is the first to directly compare radiation therapy to catheter ablation for patients with a dangerous condition called ventricular tachycardia (VT).
VT is a serious heart rhythm problem that can lead to fainting, heart failure, or sudden death.
VT patients are often very ill. Many rely on strong medications that come with harsh side effects, and some have implantable defibrillators that shock their hearts back into rhythm.
If medications stop working, doctors usually turn to catheter ablation.
In this procedure, doctors insert a tube through the leg and into the heart to burn away the tissue causing the abnormal rhythm. While ablation helps many patients, it becomes riskier with each repeat procedure, especially for those in fragile health.
Radiation therapy offers a different approach. Known as stereotactic arrhythmia radiation therapy (or STAR), this method targets the damaged heart tissue using focused beams of radiation—no surgery or anesthesia needed. The goal is the same: stop the abnormal rhythm and allow the heart to beat normally.
In this study, doctors looked back at 43 very sick patients treated for end-stage VT between 2015 and 2018. All had previously tried medication, and most had already undergone at least one catheter ablation. Some were too sick to attempt another. Of these patients, 22 received radiation therapy and 21 had another ablation.
The results were encouraging. Patients treated with radiation had far fewer serious complications. Only two patients in the radiation group had side effects that required hospitalization, compared to eight in the ablation group.
Problems also happened sooner with ablation—most within a week—while issues after radiation didn’t show up until around 10 months later.
Tragically, four patients in the ablation group died within one month of the procedure, and one passed away during the treatment itself. None of the patients in the radiation group died from treatment-related problems in the three years following therapy.
Dr. Shannon Jiang, the study’s lead author, explained that avoiding anesthesia is a big reason why radiation may be safer. For patients who are already very sick, going under anesthesia for an invasive procedure can carry serious risks. Since radiation is noninvasive, it avoids many of these dangers.
When it came to effectiveness, both treatments performed similarly. Patients in both groups went about eight to nine months before experiencing another serious heart rhythm issue.
Overall survival was higher in the radiation group—28 months compared to 12 months—but the small study size means more research is needed to confirm this.
This early research shows that radiation may be a safe and effective option for patients with life-threatening VT, especially those who are not well enough for another surgery.
Dr. Jiang emphasized the need for larger studies and highlighted an ongoing international clinical trial called RADIATE-VT, which will further explore the potential of this treatment.
Although few hospitals currently offer radiation therapy for VT, this research could help make it more widely available. It gives new hope to patients for whom other treatments have failed.
If you care about heart health, please read studies that Changing blood pressure readings is a hidden sign of heart disease and common type 2 diabetes drugs may raise heart risk.
For more about heart health, please read studies about root cause of heart rhythm disorders and Warning signal from the kidneys can predict future heart failure risk.
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