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STOPSTORM: stereotactische bestraling reduceert refractaire VT met 80%

Het Europese STOPSTORM-register volgde 193 patiënten (88% man, 53% niet-ischemische cardiomyopathie) na stereotactische arrhythmieradioablatie (STAR) voor refractaire ventriculaire tachycardie. Bij 107 patiënten met ≥6 maanden follow-up daalde de mediane VT-burden 80% in de zes maanden na STAR; 72% van hen bleef vrij van ICD-shocks.

Twaalf ernstige bijwerkingen werden geadjudiceerd als mogelijk of waarschijnlijk behandelingsgerelateerd, waaronder pericardeffusie en coronaire events. De algemene 12-maandsoverleving was 77%.

Abstract (original)

BACKGROUND AND AIMS: Stereotactic arrhythmia radioablation (STAR) is increasingly used for refractory ventricular tachycardia (VT), yet prospective multicentre outcome data remain limited. Here, the planned interim analysis of the prospective Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary (STOPSTORM) registry is reported. METHODS: STOPSTORM is a European prospective, international, multicentre registry of patients treated with STAR. The primary efficacy endpoint was the change in sustained VT episode burden comparing the 6 months before versus the 6 months after STAR. The primary safety endpoint was the occurrence of serious adverse events (SAEs) adjudicated as possibly or probably treatment-related. Overall survival was assessed using time-to-event methods. RESULTS: Across 28 centres, 193 patients were included (mean age 68±9 years; 88% male; 53% non-ischaemic cardiomyopathy). Median follow-up was 19 months. Among 107 evaluable patients with ≥6-month follow-up, the median VT episode burden was reduced by 80% after STAR. Among patients surviving ≥6 months, 72% were free from implantable cardioverter-defibrillator (ICD) shock. In the full cohort, 12 SAEs were adjudicated as possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Overall survival probability was 77% at 12 months. CONCLUSIONS: In the largest prospective multicentre cohort reported to date, STAR was associated with a substantial reduction in VT burden and ICD shocks, with a low frequency of possibly or probably treatment-related SAEs.

Dit artikel is een samenvatting van een publicatie in European heart journal. Voor het volledige artikel, alle details en referenties verwijzen wij u naar de oorspronkelijke bron.

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DOI: 10.1093/eurheartj/ehag338