Feel the rhythm.

Oh, has stereotactic body radiation (SBRT) for refractory ventricular tachycardia come a long way, from a case series of 5 patients to now reach the realm of expert consensus guidelines. One might guess many of these recommendations, which largely focus on reserving this treatment for cases with no further options for catheter ablation or medical management. The strongest consensus was that cardiac radioablation preferably be done in a clinical trial. It also emphasizes the complexity of both target delineation and target intrafraction motion management, meaning both involvement of cardiology/electrophysiology using a 3D electroanatomical mapping system and treatment with state-of-the-art SBRT delivery systems. | Krug, Heart Rhythm 2021