Stereotactic Arrhythmia Radioablation for Refractory Ventricular Tachycardia: An Interim STOPSTORM Analysis

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Summary of  European Heart Journal https://doi.org/10.1093/eurheartj/ehag338
Dr. L H G van der Pol et al.

Points

Investigators evaluated nearly two hundred patients across twenty-eight European centers to determine if non-invasive stereotactic radioablation could successfully reduce the frequency of life-threatening ventricular tachycardia events in advanced cases.
Clinical results indicated that the number of dangerous arrhythmia episodes decreased by an average of eighty percent for those who had previously failed both drug therapy and traditional catheter-based procedures.
Data showed that seventy-two percent of surviving patients remained entirely free from distressing defibrillator shocks during the six months following the delivery of a single and highly precise radiation treatment.
The study confirmed a manageable safety profile for the procedure with only twelve serious adverse events linked to the treatment and no reported deaths directly caused by the radiation therapy.
This collaborative research between cardiologists and radiation oncologists represents a significant advancement in providing a non-invasive treatment alternative for seriously ill patients who currently have very limited clinical options.

Summary

This study evaluated the efficacy and safety of stereotactic arrhythmia radioablation (STAR) for patients with refractory ventricular tachycardia (VT) who had exhausted conventional pharmacological and catheter-based interventions. Given that persistent VT is associated with high mortality and repeated implantable cardioverter-defibrillator (ICD) shocks, the STOPSTORM consortium sought to provide prospective, multicentre validation of this non-invasive modality. The interim analysis included 193 patients across 28 European centers, representing the largest prospective cohort to date receiving high-precision, single-fraction radiation for cardiac rhythm stabilization.

The analysis of 107 evaluable patients with a minimum six-month follow-up revealed an 80% average reduction in dangerous arrhythmia events compared to the six months prior to treatment. Furthermore, 72% of patients who survived the initial six-month period remained entirely free of ICD shocks. Regarding safety, only 12 serious adverse events (SAEs) were identified as possibly or probably treatment-related across the full 193-patient cohort, and no treatment-related deaths were observed. While the overall mortality rate remained high due to advanced baseline heart disease, the frequency of procedure-specific complications was notably low.

These results suggest that STAR is a viable and effective alternative for a patient population with very limited therapeutic options. The findings underscore the importance of multidisciplinary collaboration between cardiology, rhythmology, and radiation oncology to harmonize target definition and treatment protocols. By delivering precise radiation without the need for invasive catheterization, STAR may significantly reduce the clinical burden of ICD shocks and hospitalizations. Future research within the STOPSTORM registry will continue to monitor long-term outcomes and disease progression to better refine patient selection and maximize the durable effects of this novel therapeutic approach.

Link to the article: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag338/8659376?login=false

References

Van Der Pol, L. H. G., Tomasik, B., Hoeksema, W. F., Mandija, S., Miszczyk, M., Grehn, M., But Hadzic, J., Calvo, D., Crico, C., Cvek, J., Duncker, D., Hohendanner, F., Jadczyk, T., Jaschik, S., Krug, D., Levis, M., Maria De Ferrari, G., Postema, P. P. G., Schiappacasse, L., … Fast, M. F. (2026). Stereotactic arrhythmia radioablation for refractory ventricular tachycardia: The STOPSTORM.eu study. European Heart Journal, ehag338. https://doi.org/10.1093/eurheartj/ehag338