Возможности стереотаксичес­кой лучевой терапии для лечения рекуррентных желудочковых нарушений ритма: современное состояние проблемы

Рассмотрены современные подходы к применению стереотаксической радиохирургии аритмий (STAR) у пациентов с устойчивой желудочковой тахикардией, рефрактерной к медикаментозной терапии и катетерной аблации. Представлены биофизические и молекулярные механизмы терапевтического действия метода, экспериментальные данные, принципы планирования и визуализации мишени, а также международный и собственный опыт клинического применения метода у пациентов с желудочковыми тахикардиями. Отдельно изложены технические аспекты методики, нерешенные вопросы, ограничения и потенциал внедрения STAR в российскую клиническую практику.

1. Kawamura M, Shimojo M, Tatsugami F, et al. Stereotactic arrhythmia radioablation for ventricular tachycardia: a review of clinical trials and emerging roles of imaging. J Radiat Res. 2025 Jan;66(1): 1-9. https://doi.org/10.1093/jrr/rrae090.

2. Kong MH, Fonarow GC, Peterson ED, et al. Systematic review of the incidence of sudden cardiac death in the United States. J Am Coll Cardiol. 2011 Feb;57(7): 794-801.

3. Ревишвили А.Ш. Неинвазивная диагностика и аблация аритмий - миф или реальность? Вестник аритмологии. 2020;27(3): 5-8. https://doi.org/10.35336/VA-2020-3-5-8.

4. Moss AJ, Schuger C, Beck CA, et al. Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med. 2012 Dec;367(24): 2275-83. https://doi.org/10.1056/NEJMoa1211107.

5. Fernandez-Armenta J, Soto-Iglesias D, Silva E, et al. Safety and outcomes of ventricular tachycardia substrate ablation during sinus rhythm: A prospective multicenter registry. JACC Clin Electrophysiol. 2020 Nov;6(11): 1435- 48. https://doi.org/10.1016/j.jacep.2020.07.028.

6. Ciaccio EJ, Anter E, Coromilas J, et al. Structure and function of the ventricular tachycardia isthmus. Heart Rhythm. 2022 Jan;19(1): 137-53. https://doi.org/10.1016/j.hrthm.2021.08.001.

7. Wei C, Qian P, Tedrow U, et al. Non-invasive stereotactic radioablation: a new option for the treatment of ventricular arrhythmias. Arrhythm Electrophysiol Rev. 2020 Dec;8(4): 285-93. https://doi.org/10.15420/aer.2019.04.

8. Whitaker J, Mak RH, Zei PC. Non-invasive ablation of arrhythmias with stereotactic ablative radiotherapy. Trends Cardiovasc Med. 2022 Jul;32(5): 287-96. https://doi.org/10.1016/j.tcm.2021.04.008.

9. Bonaparte I, Gregucci F, Surgo A, et al. Linac-based STereotactic Arrhythmia Radioablation (STAR) for ventricular tachycardia: a treatment planning study. Jpn J Radiol. 2021 Dec;39(12): 1223-8. https://doi.org/10.1007/s11604-021-01159-9.

10. Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022 Oct;43(40): 3997-4126. https://doi.org/10.1093/eurheartj/ehac262.

11. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice guidelines and the Heart Rhythm Society. Circulation. 2018 Sep;138(13): e272-e391. https://doi.org/10.1161/CIR.0000000000000549.

12. Guckenberger M, Baus WW, Blanck O, et al. Definition and quality requirements for stereotactic radiotherapy: Consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery. Strahlenther Onkol. 2020 May;196(5): 417-20. https://doi.org/10.1007/s00066-020-01603-1.

13. Schmitt D, Blanck O, Gauer T, et al. Technological quality requirements for stereotactic radiotherapy: Expert review group consensus from the DGMP Working Group for Physics and Technology in Stereotactic Radiotherapy. Strahlenther Onkol. 2020 May;196(5): 421-43. https://doi.org/10.1007/s00066-020-01583-2.

14. Sanuki N, Takeda A, Tsurugai Y, et al. Role of stereotactic body radiotherapy in multidisciplinary management of liver metastases in patients with colorectal cancer. Jpn J Radiol. 2022 Oct;40(10): 1009-16. https://doi.org/10.1007/s11604-022-01307-9.

15. Ito K, Nakajima Y, Ikuta S. Stereotactic body radiotherapy for spinal oligometastases: a review on patient selection and the optimal methodology. Jpn J Radiol. 2022 Oct;40(10): 1017-23. https://doi.org/10.1007/s11604-022-01277-y.

16. Kimura T, Fujiwara T, Kameoka T, et al. Stereotactic body radiation therapy for metastatic lung metastases. Jpn J Radiol. 2022 Oct;40(10): 995-1005. https://doi.org/10.1007/s11604-022-01323-9.

17. Timmerman R. A story of hypofractionation and the table on the wall. Int J Radiat Oncol Biol Phys. 2022 Jan;112(1): 4-21. https://doi.org/10.1016/j.ijrobp.2021.09.027.

18. Diez P, Hanna GG, Aitken KL, et al. UK 2022 consensus on normal tissue dose-volume constraints for oligometastatic, primary lung and hepatocellular carcinoma stereotactic ablative radiotherapy. Clin Oncol (R Coll Radiol). 2022 May;34(5): 288-300. https://doi.org/10.1016/j. clon.2022.02.010.

19. Cuculich PS, Schill MR, Kashani R, et al. Noninvasive Cardiac Radiation for Ablation of Ventricular Tachycardia. N Engl J Med. 2017 Dec;377(24): 2325-36. https://doi.org/10.1056/NEJMoa1613773.

20. Hašková J, Wichterle D, Kautzner J, et al. Efficacy and safety of stereotactic radiotherapy in patients with recurrent ventricular tachycardias: the Czech experience. JACC Clin Electrophysiol. 2024 Apr;10(4): 654-66. https://doi.org/10.1016/j.jacep.2023.12.002.

21. Van der Ree MH, Blanck O, Limpens J, et al. Cardiac radioablation- A systematic review. Heart Rhythm. 2020 Aug;17(8): 1381-92. https://doi.org/10.1016/j.hrthm.2020.03.013.

22. Kovacs B, Mayinger M, Schindler M, et al. Stereotactic radioablation of ventricular arrhythmias in patients with structural heart disease − A systematic review. Radiother Oncol. 2021 Jul;160: 132-9. https://doi.org/10.1016/j.radonc.2021.06.036.

23. Miszczyk M, Jadczyk T, Goba K, et al. Clinical evidence behind stereotactic radiotherapy for the treatment of ventricular tachycardia (STAR) -A comprehensive review. J Clin Med. 2021 Mar;10(6): 1238. https://doi.org/10.3390/jcm10061238.

24. Lee E, Ibrahim EH, Parwani P, et al. Practical guide to evaluating myocardial disease by cardiac MRI. Am J Roentgenol. 2020 Mar;214(3): 546-56. https://doi.org/10.2214/AJR.19.22076.

25. Zhang DM, Navara R, Yin T, et al. Cardiac radiotherapy induces electrical conduction reprogramming in the absence of transmural fibrosis. Nat Commun. 2021 Sep;12(1): 5558. https://doi.org/10.1038/s41467-021-25730-0.

26. Amino M, Yoshioka K, Tanabe T, et al. Heavy ion radiation up-regulates Cx43 and ameliorates arrhythmogenic substrates in hearts after myocardial infarction. Cardiovasc Res. 2006 Nov;72(2): 412-21. https://doi.org/10.1016/j.cardiores.2006.09.010.

27. Mehrhof F, Hüttemeister J, Tanacli R, et al. Cardiac radiotherapy transiently alters left ventricular electrical properties and induces cardiomyocyte-specific ventricular substrate changes in heart failure. Europace. 2024 Jan;26(1): euae005. https://doi.org/10.1093/europace/euae005.

28. Glashan CA, Androulakis AFA, Tao Q, et al. Whole human heart histology to validate electroanatomical voltage mapping in patients with non-ischaemic cardiomyopathy and ventricular tachycardia. Eur Heart J. 2018 Jul;39(30): 2867-75. https://doi.org/10.1093/eurheartj/ehy168.

29. De Bakker JM, van Capelle FJ, Janse MJ, et al. Slow conduction in the infarcted human heart: ‘Zigzag’ course of activation. Circulation. 1993 Sep;88(3): 915-26. https://doi.org/10.1161/01.cir.88.3.915

30. Sharma A, Wong D, Weidlich G, et al. Noninvasive stereotactic radiosurgery (CyberHeart) for creation of ablation lesions in the atrium. Heart Rhythm. 2010 Jun;7(6): 802-10. https://doi.org/10.1016/j.hrthm.2010.02.010.

31. Blanck O, Bode F, Gebhard M, et al. Dose-escalation study for cardiac radiosurgery in a porcine model. Int J Radiat Oncol Biol Phys. 2014 Jul;89(3): 590-8. https://doi.org/10.1016/j.ijrobp.2014.02.036.

32. Cha MJ, Seo JW, Kim HJ, et al. Early changes in rat heart after high-dose irradiation: implications for antiarrhythmic effects of cardiac radioablation. J Am Heart Assoc. 2021 May;10(9): e019072. https://doi.org/10.1161/JAHA.120.019072.

33. Suzuki A, Deisher AJ, Rettmann ME, et al. Catheter-free arrhythmia ablation using scanned proton beams: electrophysiologic outcomes, biophysics, and characterization of lesion formation in a porcine model. Circ Arrhythm Electrophysiol. 2020 Sep;13(9): e008838. https://doi.org/10.1161/CIRCEP.120.008838.

34. Hohmann S, Deisher AJ, Konishi H, et al. Catheter-free ablation of infarct scar through proton beam therapy: tissue effects in a porcine model. Heart Rhythm. 2020 Dec;17(12): 2190-9. https://doi.org/10.1016/j.hrthm.2020.07.011.

35. Lehmann HI, Graeff C, Simoniello P, et al. Feasibility study on cardiac arrhythmia ablation using high-energy heavy ion beams. Sci Rep. 2016 Dec;6: 38895. https://doi.org/10.1038/srep38895.

36. Amino M, Yoshioka K, Furusawa Y, et al. Inducibility of ventricular arrhythmia 1 year following treatment with heavy ion irradiation in dogs with myocardial infarction. Pacing Clin Electrophysiol. 2017 Mar;40(3): 379-90. https://doi.org/10.1111/pace.13031.

37. Hohmann S, Deisher AJ, Suzuki A, et al. Left ventricular function after noninvasive cardiac ablation using proton beam therapy in a porcine model. Heart Rhythm. 2019 Oct;16(10): 1710-9. https://doi.org/10.1016/j.hrthm.2019.04.030.

38. Pérez-Castellano N, Villacastín J, Aragoncillo P, et al. Pathological effects of pulmonary vein beta-radiation in a swine model. J Cardiovasc Electrophysiol. 2006 Jun;17(6): 662-9. https://doi.org/10.1111/j.1540-8167.2006.00462.x.

39. Bode F, Blanck O, Gebhard M, et al. Pulmonary vein isolation by radiosurgery: implications for non-invasive treatment of atrial fibrillation. Europace. 2015 Dec;17(12): 1868-74. https://doi.org/10.1093/europace/euu406.

40. Васковский ВА, Таймасова ИА, Калинин ДВ, и др. Применение стереотаксической радиохирургии в эксперименте на крупных животных для проведения неинвазивных вмешательств в аритмологии. Вестник аритмологии. 2021;28(1): 5-13. https://doi.org/10.35336/VA-2021-1-5-13.

41. Kovacs B, Mayinger M, Ehrbar S, et al. Dose escalation for stereotactic arrhythmia radioablation of recurrent ventricular tachyarrhythmia-a phase II clinical trial. Radiat Oncol. 2023 Nov;18(1): 185. https://doi.org/10.1186/s13014-023-02361-x.

42. Gupta S, Desjardins B, Baman T, et al. Delayed-enhanced MR scar imaging and intraprocedural registration into an electroanatomical mapping system in post-infarction patients. JACC Cardiovasc Imaging. 2012 Feb;5(2): 207-10. https://doi.org/10.1016/j.jcmg.2011.08.021.

43. Piers SRD, Tao Q, de Riva Silva M, et al. CMR-based identification of critical isthmus sites of ischemic and nonischemic ventricular tachycardia. JACC Cardiovasc Imaging. 2014 Jul;7(7): 774-84. https://doi.org/10.1016/j.jcmg.2014.03.013.

44. Yamashita S, Sacher F, Mahida S, et al. Image integration to guide catheter ablation in scar-related ventricular tachycardia. J Cardiovasc Electrophysiol. 2016 Jun;27(6): 699-708. https://doi.org/10.1111/jce.12963.

45. Codreanu A, Odille F, Aliot E, et al. Electroanatomic characterization of post-infarct scars: comparison with 3-dimensional myocardial scar reconstruction based on magnetic resonance imaging. J Am Coll Cardiol. 2008 Aug;52(10): 839-42. https://doi.org/10.1016/j.jacc.2008.05.038.

46. Dickfeld T, Tian J, Ahmad G, et al. MRI-guided ventricular tachycardia ablation: integration of late gadolinium-enhanced 3D scar in patients with implantable cardioverter-defibrillators. Circ Arrhythm Electrophysiol. 2011 Apr;4(2): 172-84. https://doi.org/10.1161/CIRCEP.110.958744.

47. Sasaki T, Miller CF, Hansford R, et al. Myocardial structural associations with local electrograms: a study of postinfarct ventricular tachycardia pathophysiology and magnetic resonance-based noninvasive mapping. Circ Arrhythm Electrophysiol. 2012 Dec;5(6): 1081-90. https:// doi.org/10.1161/CIRCEP.112.970699.

48. Grehn M, Mandija S, Miszczyk M, et al. STereotactic Arrhythmia Radioablation (STAR): the Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary consortium (STOPSTORM.eu) and review of current patterns of STAR practice in Europe. Europace. 2023 Apr;25(4): 1284-95. https://doi.org/10.1093/europace/euac238.

49. Krug D, Blanck O, Andratschke N, et al. Recommendations regarding cardiac stereotactic body radiotherapy for treatment-refractory ventricular tachycardia. Heart Rhythm. 2021 Dec;18(12): 2137-45. https://doi.org/10.1016/j.hrthm.2021.08.004.

50. Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the cardiac imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002 Jan;105(4): 539-42. https://doi.org/10.1161/hc0402.102975.

51. Haberl C, Crean AM, Zelt JGE, et al. Role of nuclear imaging in cardiac stereotactic body radiotherapy for ablation of ventricular tachycardia. Semin Nucl Med. 2024 Jul;54(4): 427-37. https://doi.org/10.1053/j.semnuclmed.2024.03.002.

52. Amino M, Kabuki S, Kunieda E, et al. Interim report of a Japanese phase II trial for cardiac stereotactic body radiotherapy in refractory ventricular tachycardia - focus on target determination. Circ Rep. 2023 Jan;5(2): 69-79. https://doi.org/10.1253/circrep.CR-23-0003.

53. Gimelli A, Menichetti F, Soldati E, et al. Predictors of ventricular ablation’s success: viability, innervation, or mismatch? J Nucl Cardiol. 2021 Feb;28(1): 175-83. https://doi.org/10.1007/s12350-018-01575-x.

54. Loo BW Jr, Soltys SG, Wang L, et al. Stereotactic ablative radiotherapy for the treatment of refractory cardiac ventricular arrhythmia. Circ Arrhythm Electrophysiol. 2015 Aug;8(4): 748-50. https://doi.org/10.1161/CIRCEP.115.002765.

55. Robinson CG, Samson PP, Moore KMS, et al. Phase I/ II trial of electrophysiology-guided noninvasive cardiac radioablation for ventricular tachycardia. Circulation. 2019 Jan;139(3): 313-21. https://doi.org/10.1161/CIRCULATIONAHA.118.038261.

56. Bernstein HM, Leon W, Daly ME, et al. Noninvasive stereotactic radiation for refractory ventricular tachycardia after failure of cardiac sympathetic denervation. JACC Case Rep. 2022 Aug;4(15): 1189-94. https://doi.org/10.1016/j.jaccas.2022.06.025.

57. Wight J, Bigham T, Schwartz A, et al. Long term follow-up of stereotactic body radiation therapy for refractory ventricular tachycardia in advanced heart failure patients. Front Cardiovasc Med. 2022 May;9: 849113. https://doi.org/10.3389/fcvm.2022.849113.

58. Yugo D, Lo LW, Wu YH, et al. Case series on stereotactic body radiation therapy in non-ischemic cardiomyopathy patients with recurrent ventricular tachycardia. Pacing Clin Electrophysiol. 2021 Jul;44(7): 1085-93. https://doi.org/10.1111/pace.14254.

59. Boda-Heggemann J, Blanck O, Mehrhof F, et al. Interdisciplinary clinical target volume generation for cardiac radioablation: multicenter benchmarking for the RAdiosurgery for VENtricular TAchycardia (RAVENTA) trial. Int J Radiat Oncol Biol Phys. 2021 Apr;110(3): 745-56. https://doi.org/10.1016/j.ijrobp.2021.01.028.

60. Esposito A, Palmisano A, Antunes S, et al. Cardiac CT with delayed enhancement in the characterization of ventricular tachycardia structural substrate: relationship between CT-segmented scar and electro-anatomic mapping. JACC Cardiovasc Imaging. 2016 Jul;9(7): 822-32. https://doi.org/10.1016/j.jcmg.2015.10.024.

61. Macias C, Nakamura K, Tung R, et al. Importance of delayed enhanced cardiac MRI in idiopathic RVOT-VT: differentiating mimics including early stage ARVC and cardiac sarcoidosis. J Atr Fibrillation. 2014 Jun;7(1): 1097. https://doi.org/10.4022/jafib.1097.

62. Tatsugami F, Higaki T, Sakane H, et al. Coronary CT angiography in patients with implanted cardiac devices: initial experience with the metal artefact reduction technique. Br J Radiol. 2016 Oct;89(1066): 20160493. https://doi.org/10.1259/bjr.20160493.

63. Liang J, Sun Y, Ye Z, et al. Second-generation motion correction algorithm improves diagnostic accuracy of single-beat coronary CT angiography in patients with increased heart rate. Eur Radiol. 2019 Aug;29(8): 4215-27. https://doi.org/10.1007/s00330-018-5929-6.

64. Matsumoto Y, Fujioka C, Yokomachi K, et al. Feasibility of deep learning-based image reconstruction for improving image quality in coronary computed tomography angiography. Sci Rep. 2023 Mar;13(1): 3636. https://doi.org/10.1038/s41598-023-30786-7.

65. Tatsugami F, Higaki T, Nakamura Y, et al. Deep learning-based image restoration algorithm for coronary CT angiography. Eur Radiol. 2019 Nov;29(10): 5322-9. https://doi.org/10.1007/s00330-019-06183-y.

66. De Santis D, Polidori T, Tremamunno G, et al. Deep learning image reconstruction algorithm: impact on image quality in coronary computed tomography angiography. Radiol Med. 2023 Jun;128(6): 434-44. https://doi.org/10.1007/s11547-023-01607-8.

67. Chen X, Mumme RP, Corrigan KL, et al. Deep learning-based automatic segmentation of cardiac substructures for lung cancers. Radiother Oncol. 2024 Feb;191: 110061. https://doi.org/10.1016/j.radonc.2023.110061.

68. Wong LM, Ai QYH, Mo FKF, et al. Convolutional neural network in nasopharyngeal carcinoma: how good is automatic delineation for primary tumor on a non-contrast-enhanced fat-suppressed T2-weighted MRI? Jpn J Radiol. 2021 May;39(5): 571-9. https://doi.org/10.1007/s11604-021-01092-x.

69. Esquivel A, Ferrero A, Mileto A, et al. Photon-Counting Detector CT: Key Points Radiologists Should Know. Korean J Radiol. 2022 Sep;23(9): 854-65. https://doi.org/10.3348/kjr.2022.0377.

70. Greffier J, Villani N, Defez D, et al. Spectral CT imaging: Technical principles of dual-energy CT and multi-energy photon-counting CT. Diagn Interv Imaging. 2023 Apr;104(4): 167-77. https://doi.org/10.1016/j.diii.2022.11.003.

71. Zeppenfeld K, Rademaker R, Al-Ahmad A, et al. Patient selection, ventricular tachycardia substrate delineation, and data transfer for stereotactic arrhythmia radioablation: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology and the Heart Rhythm Society. EP Europace. 2025 Apr;27(4): euae214. https://doi.org/10.1093/europace/euae214.

72. Weidlich GA, Hacker F, Bellezza D, et al. Ventricular tachycardia: a treatment comparison study of the CyberKnife with conventional linear accelerators. Cureus. 2018 Oct;10(10): e3445. https://doi.org/10.7759/cureus.3445.

73. Benedict SH, Yenice KM, Followill D, et al. Stereotactic body radiation therapy: the report of AAPM task group 101. Med Phys. 2010 Aug;37(8): 4078-101. https://doi.org/10.1118/1.3438081.

74. Banfill K, Giuliani M, Aznar M, et al. Cardiac toxicity of thoracic radiotherapy: existing evidence and future directions. J Thorac Oncol. 2021 Feb;16(2): 216-27. https://doi.org/10.1016/j.jtho.2020.11.002.

75. Reis CQM, Cross A, Borsavage JM, et al. Feasibility of volumetric-modulated arc therapy gating for cardiac radioablation using real-time ECG signal acquisition and a dynamic phantom. Med Phys. 2025 Mar;52(3): 1758-68. https://doi.org/10.1002/mp.17582.

76. Piccolo C, Vigorito S, Rondi E, et al. Phantom study of stereotactic radioablation for ventricular tachycardia (STRA-MI-VT) using Cyberknife Synchrony Respiratory Tracking System with a single fiducial marker. Phys Med. 2022 Aug;100: 135-41. https://doi.org/10.1016/j.ejmp.2022.06.019.

77. Ho LT, Chen JL, Hsu JC, et al. Long-term results of stereotactic arrhythmia radioablation for refractory ventricular Arrhythmias-A Taiwanese population study. J Formos Med Assoc. 2024 Dec;S0929-6646(24)00550-3. https://doi.org/10.1016/j.jfma.2024.11.013.

78. Robinson CG, Samson P, Moore KMS, et al. Longer term results from a phase I/II Study of EP-guided noninvasive cardiac radioablation for treatment of ventricular tachycardia (ENCORE-VT). Int J Radiat Oncol Biol Phys. 2019 Nov;105(3): 682. https://doi.org/10.1016/j.ijrobp.2019.08.032.

79. Trojani V, Grehn M, Botti A, et al. Refining Treatment Planning in STereotactic Arrhythmia Radioablation: Benchmark Results and Consensus Statement From the STOPSTORM.eu Consortium. Int J Radiat Oncol Biol Phys. 2025 Jan;121(1): 218-29. https://doi.org/10.1016/j.ijrobp.2024.07.2331.

80. Gupta A, Sattar Z, Chaaban N, et al. Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review. Europace. 2024 Dec;27(1): euae305. https://doi.org/10.1093/europace/euae305.

81. Haskova J, Jedlickova K, Cvek J, et al. Oesophagopericardial fistula as a late complication of stereotactic radiotherapy for recurrent ventricular tachycardia. Europace. 2022 May;24(5):969. https://doi.org/10.1093/europace/euab326.

82. Benali K, Zei PC, Lloyd M, et al. One-year mortality and causes of death after stereotactic radiation therapy for refractory ventricular arrhythmias: a systematic review and pooled analysis. Trends Cardiovasc Med. 2024 Jul;34(5): 488-96. https://doi.org/10.1016/j.tcm.2023.12.008.

83. Ревишвили АШ, Васковский ВА, Артюхина ЕА, и др. Применение стереотаксической радиоаблации в клинической практике для лечения пациента с желудочковой тахикардией: клиническое наблюдение. Вестник аритмологии. 2022;29(4): 66-72. https://doi.org/10.35336/VA-2022-4-10.

84. Gianni C, Rivera D, Burkhardt JD, et al. Stereotactic arrhythmia radioablation for refractory scar-related ventricular tachycardia. Heart Rhythm. 2020 Aug;17(8): 1241- 8. https://doi.org/10.1016/j.hrthm.2020.02.036.

85. Carbucicchio C, Andreini D, Piperno G, et al. Stereotactic radioablation for the treatment of ventricular tachycardia: preliminary data and insights from the STRA-MIVT phase Ib/II study. J Interv Card Electrophysiol. 2021 Nov;62(2): 427-39.

86. Ninni S, Gallot-Lavallée T, Klein C, et al. Stereotactic radioablation for ventricular tachycardia in the setting of electrical storm. Circ Arrhythm Electrophysiol. 2022 Jun;15(6): e010955. https://doi.org/10.1007/s10840-021-01060-5.

87. Wang K, Eblan MJ, Deal AM, et al. Cardiac toxicity after radiotherapy for stage III non-small-cell lung cancer: pooled analysis of dose-escalation trials delivering 70 to 90 Gy. J Clin Oncol. 2017 May;35(13): 1387-94. https://doi.org/10.1200/JCO.2016.70.0229.

88. Bradley JD, Paulus R, Komaki R, et al. Standard-dose versus high-dose conformal radiotherapy. Lancet Oncol. 2015 Feb;16(2): 187-99. https://doi.org/10.1016/S1470-2045(14)71207-0.

89. Herrera Siklody C, Schiappacasse L, Jumeau R, et al. Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort. Europace. 2023;25: euad268. https://doi.org/10.1093/europace/euad268.

90. Kong FM, Moiseenko V, Zhao J, et al. Organs at risk considerations for thoracic stereotactic body radiation therapy: what is safe for lung parenchyma? Int J Radiat Oncol Biol Phys. 2021 May;110(1): 172-87. https://doi.org/10.1016/j.ijrobp.2018.11.028.

91. Nuyttens JJ, Moiseenko V, McLaughlin M, et al. Esophageal dose tolerance in patients treated with stereotactic body radiation therapy. Semin Radiat Oncol. 2016;26(2): 120-8. https://doi.org/10.1016/j.semradonc.2015.11.006.

92. Van der Ree MH, Luca A, Herrera Siklody C, et al. Effects of stereotactic arrhythmia radioablation on left ventricular ejection fraction and valve function over time. Heart Rhythm. 2023 Sep;20(9): 1206-7. https://doi.org/10.1016/j.hrthm.2023.05.022.

93. Van der Ree MH, Hoeksema WF, Luca A, et al. Stereotactic arrhythmia radioablation: a multicenter pre-post intervention safety evaluation of the implantable cardioverter-defibrillator function. Radiother Oncol. 2023 Dec;189: 109910. https://doi.org/10.1016/j.radonc.2023.109910.

94. Blanck O, Buergy D, Vens M, et al. Radiosurgery for ventricular tachycardia: preclinical and clinical evidence and study design for a German multi-center multi-platform feasibility trial (RAVENTA). Clin Res Cardiol. 2020;109(11): 1319-32. https://doi.org/10.1007/s00392-020-01650-9.

95. Nagashima K, Choi EK, Tedrow UB, et al. Reentrant Ventricular Tachycardia Originating From the Aortic Root in Patients Without Overt Structural Heart Disease. Circ Arrhythm Electrophysiol. 2014 Oct;7(5): 883-8. https://doi.org/10.1161/CIRCEP.113.000870.

96. Sapp JL, Wells GA, Parkash R, et al. Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs. N Engl J Med. 2016 Jul;375(2): 111-21. https://doi.org/10.1056/NEJMoa1513614.

97. Virk SA, Kumar S. Catheter Ablation of Ventricular Tachycardia in Patients With Structural Heart Disease: A Meta-Analysis. 2023 Feb;9(2): 255-7.

98. Reddy RK, Howard JP, Ahmad Y, et al. Cardiac Stereotactic Ablative Radiotherapy for Ventricular Tachycardia: State of the Art Review. Arrhythm Electrophysiol Rev. 2023 May;12: e26. https://doi.org/10.1136/openhrt-2021-001770.

99. Таймасова ИА, Васковский ВА, Артюхина ЕА, и др. Возможности и перспективы применения стереотаксической радиохирургии для проведения неинвазивных вмешательств в аритмологии. Вестник аритмологии. 2020;27(4):33-41. https://doi.org/10.35336/VA-2020-4-33-41.