Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams.
High-energy ion beams are successfully used in cancer therapy and precisely deliver high doses of ionizing radiation to small deep-seated target volumes. A similar noninvasive treatment modality for cardiac arrhythmias was tested here. This study used high-energy carbon ions for ablation of cardiac tissue in pigs. Doses of 25, 40, and 55 Gy were applied in forced-breath-hold to the atrioventricular junction, left atrial pulmonary vein junction, and freewall left ventricle of intact animals. Procedural success was tracked by (1.) in-beam positron-emission tomography (PET) imaging; (2.) intracardiac voltage mapping with visible lesion on ultrasound; (3.) lesion outcomes in pathohistolgy. High doses (40-55 Gy) caused slowing and interruption of cardiac impulse propagation. Target fibrosis was the main mediator of the ablation effect. In irradiated tissue, apoptosis was present after 3, but not 6 months. Our study shows feasibility to use high-energy ion beams for creation of cardiac lesions that chronically interrupt cardiac conduction.
Lehmann, HI; Graeff, C; Simoniello, P; Constantinescu, A; Takami, M; Lugenbiel, P; Richter, D; Eichhorn, A; Prall, M; Kaderka, R; Fiedler, F; Helmbrecht, S; Fournier, C; Erbeldinger, N; Rahm, A-K; Rivinius, R; Thomas, D; Katus, HA; Johnson, SB; Parker, KD; Debus, J; Asirvatham, SJ; Bert, C; Durante, M; Packer, DL
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