Abstract：
Patients treated with cardiac stereotactic body radiation therapy (radioablation) for refractory ventricular arrhythmias are patients with advanced structural heart disease and significant comorbidities. However, data regarding 1-year mortality after the procedure are scarce. This systematic review and pooled analysis aimed at determining 1-year mortality after cardiac radioablation for refractory ventricular arrhythmias and investigating leading causes of death in this population. MEDLINE/EMBASE databases were searched up to January 2023 for studies including patients undergoing cardiac radioablation for the treatment of refractory ventricular arrhythmias. Quality of included trials was assessed using the NIH Tool for Case Series Studies (PROSPERO CRD42022379713). A total of 1,151 references were retrieved and evaluated for relevance. Data were extracted from 16 studies, with a total of 157 patients undergoing cardiac radioablation for refractory ventricular arrhythmias. Pooled 1-year mortality was 32 % (95 %CI: 23-41), with almost half of the deaths occurring within three months after treatment. Among the 157 patients, 46 died within the year following cardiac radioablation. Worsening heart failure appeared to be the leading cause of death (52 %), although non-cardiac mortality remained substantial (41 %) in this population. Age≥70yo was associated with a significantly higher 12-month all-cause mortality (p<0.022). Neither target volume size nor radiotherapy device appeared to be associated with 1-year mortality (p = 0.465 and p = 0.199, respectively). About one-third of patients undergoing cardiac stereotactic body radiation therapy for refractory ventricular arrhythmias die within the first year after the procedure. Worsening heart failure appears to be the leading cause of death in this population.
摘要：
使用心脏立体定向身体放射治疗（放射消融）治疗难治性室性心律失常的患者是患有晚期结构性心脏病和严重合并症的患者。然而,有关手术后1年死亡率的数据很少.这项系统评价和汇总分析旨在确定心脏射频消融治疗难治性室性心律失常后1年的死亡率，并调查该人群的主要死亡原因。截至2023年1月，在MEDLINE/EMBASE数据库中搜索了包括接受心脏放射消融治疗难治性室性心律失常患者在内的研究。使用NIH病例系列研究工具（PROSPEROCRD42022379713）评估纳入试验的质量。共检索并评估了1,151个参考文献的相关性。数据来自16项研究，共有157例患者因难治性室性心律失常而接受心脏放射消融术。合并1年死亡率为32%(95CI:23-41)，几乎一半的死亡发生在治疗后的三个月内。在157名患者中，46人在心脏射频消融后一年内死亡。恶化的心力衰竭似乎是死亡的主要原因（52％），尽管该人群的非心脏死亡率仍然很高(41%).年龄≥70岁与显著较高的12个月全因死亡率相关(p<0.022)。目标体积大小和放射治疗装置均未显示与1年死亡率相关（分别为p=0.465和p=0.199）。接受心脏立体定向身体放射治疗的难治性室性心律失常的患者中约有三分之一在手术后的第一年内死亡。恶化的心力衰竭似乎是该人群死亡的主要原因。
