Ventricular tachycardia has a significant recurrence rate after ablation for several reasons, including inaccessible substrate. A non-invasive technique to ablate any defined areas of myocardium involved in arrhythmogenesis would be a potentially important therapeutic improvement if shown to be safe and effective. Early feasibility studies of single-fraction stereotactic body radiotherapy have demonstrated encouraging results, but rigorous evaluation and follow-up are required. In this document, the basic concepts of stereotactic body radiotherapy are summarized, before focusing on stereotactic arrhythmia radioablation. We describe the effect of radioablation on cardiac tissue and its interaction with intracardiac devices, depending on the dose. The different clinical studies on ventricular tachycardia radioablation are analysed, with a focus on target identification, which is the key feature of this approach. Our document ends with the indications and requirements for practicing this type of procedure in 2020. Finally, because of the limited number of patients treated so far, we encourage multicentre registries with long-term follow-up.

消融后心室性心动过速具有明显的复发率，原因有多种，包括难以接近的底物。如果被证明是安全有效的，消融涉及心律失常的心肌的任何定义区域的非侵入性技术将是潜在的重要治疗改进。单级立体定向身体放疗的早期可行性研究已显示出令人鼓舞的结果，但需要严格的评估和随访。在本文中，对立体定向身体放疗的基本概念进行了概述，然后重点介绍了立体定向心律不齐放射消融。我们根据剂量描述了射频消融对心脏组织的影响及其与心脏内装置的相互作用。分析了有关室性心动过速放射消融的不同临床研究，着重于目标识别，这是此方法的关键特征。我们的文件以在2020年实施此类手术的适应症和要求作为结尾。最后，由于迄今为止接受治疗的患者数量有限，我们鼓励对多中心注册进行长期随访。