Narayana Health City Uses Stereotactic Body Radiotherapy (SBRT), a Common Treatment Used to Treat Cancer, and Successfully Treats a Patient Suffering from a Complex Cardiac Ailment

• The patient becomes the first in India to have undergone Stereotactic body Radiotherapy (SBRT) for Ventricular Tachycardia

• The treatment gives a new ray of hope for those suffering from complex refractory arrhythmias

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Ventricular Tachycardia (VT) is one of the most malignant arrhythmias (rhythm disorders) of the heart which can be fatal if not treated promptly and efficiently. According to Dr. Ramakrishnakumar S nearly a third to half of them have recurrence even after optimal medications, ICD implantation and catheter ablation and these people who suffer from this condition are unsuitable for the regular treatment modalities and have high rates of mortality (Nearly 20% die in hospital and only 50% survive at the end of 6 months). Narayana Health City has brought a ray of hope for those suffering from such complex Ventricular Tachycardia (VT). The hospital has successfully treated a 43 years old patient suffering from difficult Ventricular Tachycardia (VT) through stereotactic body Radiotherapy (SBRT), a common radiation treatment used to treat cancer.

Hailing from Bellari district in Karnataka, Mr. C Hanumanthappa was referred to Narayana Health City owing to his uncontrollable recurrent VT (Ventricular Tachycardia or very fast heart rhythm originating from the lower part of the heart). A farmer by profession, Hanumanthappa had history of myocardial infarction (heart attack). In fact, the myocardial infarction that he suffered from in April 2022 had caused severe damage to his heart muscle. Further, his heart was very poorly contracting, and he had developed recurrent VT (Ventricular Tachycardia) for which he was treated with electrical shock. Mr. Hanumanthappa was admitted under the care of Dr. Ramakrishnakumar S (Senior Consultant Interventional cardiologist and Electrophysiologist), Dr. Saurabha Kumar (Senior Consultant Radiation Oncologist) and team. The team did a thorough evaluation and as his condition was critical. He was treated with optimal anti arrhythmic medications and an AICD (AICD is a special cardiac device which would detect any abnormal rhythms of the heart and treat it promptly with a delivery of small amount of electrical energy directly to the heart from the inside) was implanted.

Despite maximal medications and optimal treatment for heart failure, he continued to experience recurrent heart rhythm problem for which he received multiple electrical shocks from the device. Further, the very fast heart rates used to result in Hanumanthappa losing consciousness transiently. The continuous occurrences even lead to extreme fatigue, fear, apprehension and anxiety and affected his quality of life and he was not able to return to his occupation.

As Hanumanthappa’s condition was not showing signs of improvement, the team decided to explore other treatment modalities. One of the most commonly used procedure for VT is Cardiac ablation procedure (where the abnormal region of electrical conduction inside the heart is identified invasively and energy is delivered to prevent the abnormal electrical conduction). However in the case of Hanumanthappa doctors could not use that as he had developed a large blood clot inside his heart. Doing a procedure on patient with blood clot can lead to brain stroke. The complex condition that Hanumanthappa was suffering from limited the treatment modalities for him, however, the team of doctors did not lose hope. They decided to look beyond the usual.

During their discussion they reviewed the data wee that doctors in some of the western countries have tried Stereotactic body Radiotherapy (SBRT), a radiation therapy that is commonly used to treat cancer for such complex cardiac conditions and have seen excellent results.

The doctors discussed with the family and decided to explore this mode of treatment. The treatment modality was undertaken with the help of a comprehensive team comprising of cardiologists, radiation oncologists and radiologists. In this treatment the location of the abnormal electrical conduction was identified based on ECG, Cardiac CT and Cardiac MRI. Stereotactic body Radiotherapy (SBRT) was precisely delivered to the region of interest successfully with great accuracy and minimal damage to the cardiac and lung normal tissues around it. Hanumanthappa tolerated the procedure well and was subsequently discharged within a week after the procedure. We are proud to say that Mr. Hanumanthappa is the first patient to have undergone Stereotactic body Radiotherapy (SBRT) for ventricular Tachycardia in the country. On follow up after 6 weeks, he was found to have no recurrence of the abnormal heart rhythm & did not receive any further shocks with a good quality of life. The medications too have been tapered.

Elaborating about the treatment, Dr. Saurabha Kumar, Senior Consultant Radiation Oncologist, Narayana Health City said, “Stereotactic body Radiotherapy (SBRT) is not only an established form of treatment for early-stage cancers of the prostate, lung, pancreas, it has also been proved to be an effective form of non-invasive treatment for VT in the western countries. However, it is yet to pick up traction in our country. We are glad that we have been able to create awareness about this mode of treatment by successfully performing and saving a life.“

“We were able to do this only because of the comprehensive approach that we have at Narayana Health City. The successful treatment of Mr. Hanumanthappa using SBRT is not just a feather on the cardiology department but is a result of an equal effort from the Radiation Oncology department,” added Dr. Ramakrishnakumar, Senior Consultant Interventional cardiologist and Electrophysiologist, Narayana Health City.

Dr. Deepak Padmanabhan, Consultant (Adult) Cardiologist and Electrophysiology, Narayana Health City and team were also a part of the treatment.

It is a form of Radiotherapy technique where high dose of radiation is delivered using advanced linear accelerator to a target with very high precision. It is non-invasive and outpatient procedure hence there is no risk of anaesthesia, blood loss or pain.

Sharing his joy of being cured, Mr. Hanumanthappa, said, “The constant attacks and hospitalisations had taken a toll on my physical as well as mental health. I am extremely thankful towards the team of doctors at Narayana Health City. They have not only cured me of my condition, but they have also given me a new lease of life to my family as well.”

Currently, his medications have also been tapered and yet he is doing well with no further recurrences.

About Narayana Health

With all super-speciality tertiary care facilities that the medical world offers, Narayana Health is a one-stop healthcare destination for all. Founded by Dr. Devi Shetty and headquartered in Bengaluru, Narayana Health group is the second largest health care provider in the country in terms of operational bed count. The first facility was established with approximately 225 operational beds in year 2000 at NH Health City in Bengaluru. The Company today operates a chain of multispecialty tertiary and primary healthcare facilities across a network of 23 hospitals and 7 heart centres in India and single hospital overseas at Cayman Islands with nearly 5,900 operational beds across all its centres and potential to reach a capacity of over 6,800 beds.

For details, please visit www.narayanahealth.org.