Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams

H. Immo Lehmann; Christian Graeff; Palma Simoniello; Anna Constantinescu; Mitsuru Takami; Patrick Lugenbiel; Daniel Richter; Anna Eichhorn; Matthias Prall; Robert Kaderka; Fine Fiedler; Stephan Helmbrecht; Claudia Fournier; Nadine Erbeldinger; Ann Kathrin Rahm; Rasmus Rivinius; Dierk Thomas; Hugo A. Katus; Susan B. Johnson; Kay D. Parker; Jürgen Debus; Samuel J. Asirvatham; Christoph Bert; Marco Durante; Douglas L. Packer

doi:10.1038/srep38895

Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams

H. Immo Lehmann, Christian Graeff, Palma Simoniello, Anna Constantinescu, Mitsuru Takami, Patrick Lugenbiel, Daniel Richter, Anna Eichhorn, Matthias Prall, Robert Kaderka, Fine Fiedler, Stephan Helmbrecht, Claudia Fournier, Nadine Erbeldinger, Ann Kathrin Rahm, Rasmus Rivinius, Dierk Thomas, Hugo A. Katus, Susan B. Johnson, Kay D. ParkerJürgen Debus, Samuel J. Asirvatham, Christoph Bert, Marco Durante, Douglas L. Packer

Cardiovascular Medicine

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54 Scopus citations

Abstract

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.

Original language	English (US)
Article number	38895
Journal	Scientific reports
Volume	6
DOIs	https://doi.org/10.1038/srep38895
State	Published - Dec 20 2016

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Lehmann, H. I., 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, H. A., Johnson, S. B., ... Packer, D. L. (2016). Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams. Scientific reports, 6, Article 38895. https://doi.org/10.1038/srep38895

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, AK, Rivinius, R, Thomas, D, Katus, HA, Johnson, SB, Parker, KD, Debus, J, Asirvatham, SJ, Bert, C, Durante, M & Packer, DL 2016, 'Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams', Scientific reports, vol. 6, 38895. https://doi.org/10.1038/srep38895

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abstract = "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.",

author = "Lehmann, {H. Immo} and Christian Graeff and Palma Simoniello and Anna Constantinescu and Mitsuru Takami and Patrick Lugenbiel and Daniel Richter and Anna Eichhorn and Matthias Prall and Robert Kaderka and Fine Fiedler and Stephan Helmbrecht and Claudia Fournier and Nadine Erbeldinger and Rahm, {Ann Kathrin} and Rasmus Rivinius and Dierk Thomas and Katus, {Hugo A.} and Johnson, {Susan B.} and Parker, {Kay D.} and J{\"u}rgen Debus and Asirvatham, {Samuel J.} and Christoph Bert and Marco Durante and Packer, {Douglas L.}",

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AU - Graeff, Christian

AU - Simoniello, Palma

AU - Constantinescu, Anna

AU - Takami, Mitsuru

AU - Lugenbiel, Patrick

AU - Richter, Daniel

AU - Eichhorn, Anna

AU - Prall, Matthias

AU - Kaderka, Robert

AU - Fiedler, Fine

AU - Helmbrecht, Stephan

AU - Fournier, Claudia

AU - Erbeldinger, Nadine

AU - Rahm, Ann Kathrin

AU - Rivinius, Rasmus

AU - Thomas, Dierk

AU - Katus, Hugo A.

AU - Johnson, Susan B.

AU - Parker, Kay D.

AU - Debus, Jürgen

AU - Asirvatham, Samuel J.

AU - Bert, Christoph

AU - Durante, Marco

AU - Packer, Douglas L.

PY - 2016/12/20

Y1 - 2016/12/20

N2 - 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.

AB - 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.

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Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams

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