Patient population
MMVT, nonischemic cardiomyopathies, mitral and aortic valve).MMVT, Primary electrical disease, heart failure, LV thrombus
HEART FAILURE, RECURRENCE, ACUTE MYOCARDIAL INFARCTION
Following inclusion criteria are required for participation:
Patients with ischemic as well as nonischemic cardiomyopathies.Implanted ICD or CRT-D.Prior ≥ 1 failed CA (with endocardial ± epicardial approach based on the substrate location and the ECG morphology of clinical VT) procedure to control sustained MMVT using currently recommended mapping and ablation techniques.Patients in whom ablation is not feasible or contraindicated (e.g. LV thrombus or mechanical mitral and aortic valve).MMVT recurrence after CA on optimized antiarrhythmic and heart failure medication.Age ≥ 18 years.IRB-approved, written informed consent as documented by signature.Exclusion Criteria [
Patients with MMVT who demonstrate:
Acute myocardial infarction.Primary electrical disease (channelopathy).Reversible and treatable cause (e.g., drug-induced or intoxication) of VT that can be adequately addressed otherwise.A target that cannot be safely and precisely defined based on stereotactic radiotherapy accuracy requirements (e.g., anatomical interference from OARs, overlapping prior radiation therapy to the thoracic region).Pregnancy or breastfeeding.Inability to provide informed consent.