STOPSTORM registry links radioablation to reduced refractory ventricular tachycardia burden

Stereotactic arrhythmia radioablation (STAR) is increasingly used for refractory ventricular tachycardia (VT), but prospective multicentre evidence remains limited. A planned interim analysis of the European STOPSTORM registry included 193 patients across 28 centres. Mean age was 68 years, 88% were male, and 53% had non-ischaemic cardiomyopathy. The primary efficacy endpoint compared sustained VT episode burden during the six months before and after STAR; the primary safety endpoint captured serious adverse events adjudicated as possibly or probably treatment-related.

Median follow-up was 19 months. Among 107 evaluable patients with at least six months of follow-up, median VT episode burden decreased by 80%. Among patients surviving at least six months, 72% were free from implantable cardioverter-defibrillator shocks. In the full cohort, 12 serious adverse events were considered possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Estimated overall survival at 12 months was 77%.

These findings support further evaluation of STAR for refractory VT, but the observational before-and-after comparison cannot establish causality. Efficacy assessment in a subset and shock outcomes restricted to six-month survivors also warrant caution when interpreting benefit. Only the abstract was available for review, limiting assessment of treatment protocols, concomitant therapies, and detailed safety outcomes.