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There is very limited experience in cRA for patients undergoing left ventricular assist device (LVAD) therapy. We present clinical experiences of two patients treated with cRA for incessant VT under long-term LVAD therapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Two male patients (54 and 61\u00a0years old) with terminal heart failure under LVAD therapy (both patients for 8\u00a0years) showed incessant VT despite extensive antiarrhythmic drug therapy and repeated catheter ablation. cRA with a\u00a0single dose of 25\u202fGy was applied as a\u00a0last resort strategy under compassionate use in both patients following an electroanatomical mapping procedure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Both patients displayed ongoing VT during and after the cRA procedure. Repeated attempts at post-procedural rhythm conversion failed in both patients; however, one patient was hemodynamically stabilized and could be discharged home for several months before falling prey to a\u00a0fatal bleeding complication. The second patient initially stabilized for a\u00a0few days following cRA before renewed acceleration of running VT required bilateral ablation of the stellate ganglion; the patient died 50\u00a0days later. No immediate side effects of cRA were detected in either patient.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>cRA might serve as a\u00a0last resort strategy for patients with terminal heart failure undergoing LVAD therapy and displaying incessant VT. Intermediate- and long-term outcomes of these seriously ill patients often remain poor; therefore, best supportive care strategies should also be evaluated as long as no clear beneficial effects of cRA procedures can be shown. For patients treated with cRA under running ventricular rhythm abnormality, strategies for post-procedural generation of stabilized rhythm have to be established.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-023-02045-1","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T20:33:45Z","timestamp":1675802025000},"page":"511-519","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cardiac radioablation of incessant ventricular tachycardia in patients with terminal heart failure under permanent left ventricular assist device therapy\u2014description of two cases"],"prefix":"10.1007","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0553-4290","authenticated-orcid":false,"given":"Felix","family":"Mehrhof","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Bergengruen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Hong","family":"Gerds-Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Jahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Kathrin","family":"Kluge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Parwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif-Hendrik","family":"Boldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Sch\u00f6nrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"2045_CR1","doi-asserted-by":"publisher","first-page":"e91","DOI":"10.1016\/j.jacc.2017.10.054","volume":"72","author":"SM Al-Khatib","year":"2018","unstructured":"Al-Khatib\u00a0SM, Stevenson\u00a0WG, Ackerman\u00a0MJ, Bryant\u00a0WJ, Callans\u00a0DJ, Curtis\u00a0AB, Deal\u00a0BJ, Dickfeld\u00a0T, Field\u00a0ME, Fonarow\u00a0GC, Gillis\u00a0AM, Granger\u00a0CB, Hammill\u00a0SC, Hlatky\u00a0MA, Joglar\u00a0JA, Kay\u00a0GN, Matlock\u00a0DD, Myerburg\u00a0RJ, Page\u00a0RL (2018) AHA\/ACC\/HRS Guideline for Management of Patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines and the Heart Rhythm Society. 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