This is an observational study of 10 Chagas Disease patients with Ventricular Tachycardia that have failed prior catheter ablation or have this procedure contraindicated due to clinical status. Those patients will underwent to Stereotactic Body Radiation Therapy (SBRT) targeting the area of the heart of the VT circuits. Radioablation target will be defined based on prior ablation electroanatomical mapping, VT morphology, pre-acquired imaging (CT angiogram, Cardiac Magnetic Resonance), current imaging reconstructed and integrated to electroanatomical mapping and a EP study to define current VT morphologies. Gross targeted volume (GTV), internal targeted volume (ITV) and planning targeted volume (PTV) will be defined and calculated and a single 25Gy dose will be delivered to the PTV. Patients will be followed initially for one year and efficacy endpoint will be rate of VT recurrence, time to recurrence and VT burden. Safety endpoint will be the occurrence of any adverse effect related to SBRT.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
ā. Diagnosis of Chagas heart disease including positive serology
ā. Recurrent sustained ventricular tachycardia requiring therapy due to symptoms, ICD shocks, or requiring hospitalization.
ā. Age\>18 years.
ā. Able to give written, informed consent. If the patient requires continuous sedation/anesthesia for arrhythmia control consent can be provided by the next of kin.
ā. Medically fit to undergo radiation planning and treatment sessions.
ā. Failed antiarrhythmic medications due to VT recurrence, drug intolerance, or contraindication.
ā. Failed prior catheter ablation due to arrhythmia recurrence or ineligible for endocardial or epicardial catheter ablation (LV thrombus, epicardial adhesion, megacolon, prior open chest surgery)
Exclusion criteria
ā. Cardiogenic shock not due to VT with no possibility of heart transplant or ventricular assist device.
ā
What they're measuring
1
Safety of SBRT for the treatment of Ventricular Tachycardia
Timeframe: 12 months
2
Efficacy of SBRT for the treatment of Ventricular Tachycardia