Stereotactic arrhythmia radioablation: a novel therapy for cardiac arrhythmia.

Cardiac arrhythmia is a global health problem, and catheter ablation has been one of its main treatments for decades. However, catheter ablation is an invasive method that cannot reach the deep myocardium, and it carries a considerable risk of side effects and recurrence. Therefore, it is necessary to explore a novel approach is necessary. Stereotactic body radiotherapy(SBRT), which has been widely used in the field of radiation oncology, has recently expanded in the treatment of cardiac arrhythmia; when used in this context, it is known as stereotactic arrhythmia radioablation(STAR). As a non-invasive, effective and well-tolerated treatment, STAR may be a suitable alternative method for patients with cardiac arrhythmia who are resistant or intolerant to catheter ablation. The main particles used to deliver energy in STAR are photons, protons and carbon ions. Most studies have shown the short-term effectiveness of STAR, but problems such as a high long-term recurrence rate with a cumulative VT-free survival from the published literature of 38.6%, and related complications have also emerged. Therefore, in this article, we review the application of SBRT in cardiac arrhythmia, analyze its potential problems and explore methods for improvement.