Stereotactic arrhythmia radioablation for refractory ventricular tachycardia: the STOPSTORM.eu study

BACKGROUND AND AIMS: Stereotactic arrhythmia radioablation (STAR) is increasingly used for refractory ventricular tachycardia (VT), yet prospective multicentre outcome data remain limited. Here, the planned interim analysis of the prospective Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary (STOPSTORM) registry is reported. METHODS: STOPSTORM is a European prospective, international, multicentre registry of patients treated with STAR. The primary efficacy endpoint was the change in sustained VT episode burden comparing the 6 months before versus the 6 months after STAR. The primary safety endpoint was the occurrence of serious adverse events (SAEs) adjudicated as possibly or probably treatment-related. Overall survival was assessed using time-to-event methods. RESULTS: Across 28 centres, 193 patients were included (mean age 68±9 years; 88% male; 53% non-ischaemic cardiomyopathy). Median follow-up was 19 months. Among 107 evaluable patients with ≥6-month follow-up, the median VT episode burden was reduced by 80% after STAR. Among patients surviving ≥6 months, 72% were free from implantable cardioverter-defibrillator (ICD) shock. In the full cohort, 12 SAEs were adjudicated as possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Overall survival probability was 77% at 12 months. CONCLUSIONS: In the largest prospective multicentre cohort reported to date, STAR was associated with a substantial reduction in VT burden and ICD shocks, with a low frequency of possibly or probably treatment-related SAEs.

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Journal
European Heart Journal
Published
2026-04-17
DOI
https://doi.org/10.1093/eurheartj/ehag338
Primary Topic
Cardiac Arrhythmias and Treatments
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article
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article

Stereotactic arrhythmia radioablation for refractory ventricular tachycardia: the STOPSTORM.eu study

Marzia Cerrato, Wiert F. Hoeksema, Étienne Pruvot, Sławomir Blamek et al.
European Heart Journal
Cardiac Arrhythmias and Treatments
article

Stereotactic arrhythmia radioablation for refractory ventricular tachycardia: the STOPSTORM.eu study

Marzia Cerrato, Wiert F. Hoeksema, Étienne Pruvot, Sławomir Blamek, Roland Merten, Bor Antolič, Bartłomiej Tomasik, Annika Lattermann, Mateusz Sajdok, Günther Klautke, Boldizsar Kovacs, Corrado Carbucicchio, Adrian Zaman, Stefan Jaschik, Gerhard Hindricks, Moritz F. Sinner, Stefano Mandija, Mathieu Kruska, Jakub Cvek, Otakar Jiravský, Felix B. Mehrhof, Javier Quesada-Ocete, Katja Zeppenfeld, Michele Magnocavallo, Judit Boda‐Heggemann, Joanna Kamińska, M. Algara, Tomasz Jadczyk, Jorge Solana Muñoz, Melanie Grehn, David A. Krug, Tomasz Latusek, Nicolaus Andratschke, Giulio Molon, Dirk Rades, Felix Hohendanner, Marcin Miszczyk, Luis Schiappacasse, Łukasz Dolla, Mauro Iori, Piedad Almendros Blanco, Olgun Eliçin, Maiwand Ahmadsei, B. Balgobind, Jiří Plášek, Jacek Bednarek, Jingyang Xie, Colien Hazelaar, Mario Levis, Micaela Ebert, Francesco Cellini, David Duncker, Lukas Seiß, Thomas Brunner, Marian Christoph, S Corradini, Chiara Crico, PG Postema, Robert Rademaker, Lukáš Knybel, Marc D. Lemoine, Ardan Saguner, Franziska Hausmann, G M De Ferrari, R M A Ter Bekke, V Dusi, Ajra Šečerov Ermenc, Claudia Herrera Siklody, María del Pino Alcántara, Coen R N Rasch, Oliver Blanck, Evgeny Lian, Joost J C Verhoeff, Matteo Anselmino, Barbara A Jereczek-Fossa, Daniel Scherr, L H G van der Pol, Niccolò Giaj-Levra, Christian Veltmann, M F Fast, Roland Tilz, David Calvo, Gustavo Pozo Rodigriuez, Jasna But Hadzic
article en

Abstract

BACKGROUND AND AIMS: Stereotactic arrhythmia radioablation (STAR) is increasingly used for refractory ventricular tachycardia (VT), yet prospective multicentre outcome data remain limited. Here, the planned interim analysis of the prospective Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary (STOPSTORM) registry is reported. METHODS: STOPSTORM is a European prospective, international, multicentre registry of patients treated with STAR. The primary efficacy endpoint was the change in sustained VT episode burden comparing the 6 months before versus the 6 months after STAR. The primary safety endpoint was the occurrence of serious adverse events (SAEs) adjudicated as possibly or probably treatment-related. Overall survival was assessed using time-to-event methods. RESULTS: Across 28 centres, 193 patients were included (mean age 68±9 years; 88% male; 53% non-ischaemic cardiomyopathy). Median follow-up was 19 months. Among 107 evaluable patients with ≥6-month follow-up, the median VT episode burden was reduced by 80% after STAR. Among patients surviving ≥6 months, 72% were free from implantable cardioverter-defibrillator (ICD) shock. In the full cohort, 12 SAEs were adjudicated as possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Overall survival probability was 77% at 12 months. CONCLUSIONS: In the largest prospective multicentre cohort reported to date, STAR was associated with a substantial reduction in VT burden and ICD shocks, with a low frequency of possibly or probably treatment-related SAEs.

European Heart Journal
Università Cattolica del Sacro Cuore (IT), Leiden University (NL), University of Ljubljana (SI), Universität Hamburg (DE), Medical University of Silesia (PL), Universitat Pompeu Fabra (ES), Utrecht University (NL), Medical University of Graz (AT), Heidelberg University (DE), Leiden University Medical Center (NL), Maastricht University Medical Centre (NL), University Hospital of Bern (CH), Ljubljana University Medical Centre (SI), University Hospital Heidelberg (DE), Agostino Gemelli University Polyclinic (IT), University Medical Center (US), Hospital Clínico San Carlos (ES), University Medical Center Utrecht (NL), LMU Klinikum (DE), Institute of Oncology Ljubljana (SI), Maastricht University (NL), Medizinische Hochschule Hannover (DE), University Hospital Ostrava (CZ), Centro Cardiologico Monzino (IT), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), Graz University Hospital (AT), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (ES), University Hospital of Zurich (CH), Hospital Universitario 12 De Octubre (ES), Ospedale Sacro Cuore Don Calabria (IT), Deutsches Herzzentrum der Charité (DE), Fatebenefratelli Hospital (IT), University Medical Center Hamburg-Eppendorf (DE), Department of Medical Sciences (RU), University Hospital Schleswig-Holstein (DE), National Institute of Oncology (HU), Nemocnice Podlesí (CZ), Hospital General Universitario De Valencia (ES), Institute of Clinical and Experimental Medicine (CZ), Department of Medical Sciences (BY), Hospital Del Mar (ES), Amsterdam University Medical Centers (NL), University Medical Centre Mannheim (DE), Fondazione IRCCS Istituto Nazionale dei Tumori (IT), Maastro Clinic (NL), University Hospital Carl Gustav Carus (DE), Klinikum Chemnitz (DE), University of Turin (IT), European Institute of Oncology (IT), Gdańsk Medical University (PL), Charité - Universitätsmedizin Berlin (DE), Ludwig-Maximilians-Universität München (DE), University of Amsterdam (NL), University of Lübeck (DE), University of Lausanne (CH)
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Cardiac Arrhythmias and Treatments
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