AUTHOR=Pavone Chiara , Scacciavillani Roberto , Narducci Maria Lucia , Cellini Francesco , Pelargonio Gemma , Bencardino Gianluigi , Perna Francesco , Spera Francesco , Pinnacchio Gaetano , Sanna Tommaso , Valentini Vincenzo , Crea Filippo 

TITLE=Successful ventricular tachycardia radioablation in a patient with previous chemical pleurodesis: A case report

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.937090

DOI=10.3389/fcvm.2022.937090

ISSN=2297-055X

ABSTRACT=Introduction: Stereotactic arrhythmia radioablation (STAR) is a novel technique for the ablation of ventricular tachycardia in patients with contraindications to standard procedures, i.e. radiofrequency ablation. 

Case presentation: We report the case of a 73-year-old man with nonischemic dilated cardiomyopathy and recurrent VT episodes. Electroanatomic mapping showed VT prevalently of epicardial origin, but direct epicardial access through subxyphoid puncture could not be performed due to pleuropericardial adhesions from a past history of chemical pleurodesis. STAR was performed, with no VT recurrence at follow-up.

Conclusions: Previous experiences with STAR mainly focused on its application in frail end-stage heart failure subjects. Our case report demonstrates the importance of STAR as a second choice in patients with unfavorable VT anatomical locations and technical limitations to an optimal radiofrequency ablation. Moreover, it highlights STAR’s effectiveness in the ablation of complex transmural lesions.