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Atrioventricular node ablation in Langendorff-perfused porcine hearts using carbon ion particle therapy: methods and an in vivo feasibility investigation for catheter-free ablation of cardiac arrhythmias.
Lehmann, H Immo; Richter, Daniel; Prokesch, Hannah; Graeff, Christian; Prall, Matthias; Simoniello, Palma; Fournier, Claudia; Bauer, Julia; Kaderka, Robert; Weymann, Alexander; Szabó, Gábor; Sonnenberg, Karin; Constantinescu, Anna M; Johnson, Susan B; Misiri, Juna; Takami, Mitsuru; Miller, Robert C; Herman, Michael G; Asirvatham, Samuel J; Brons, Stephan; Jäkel, Oliver; Haberer, Thomas; Debus, Jürgen; Durante, Marco; Bert, Christoph; Packer, Douglas L.
Afiliação
  • Lehmann HI; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Richter D; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Prokesch H; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Graeff C; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Prall M; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Simoniello P; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Fournier C; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Bauer J; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Kaderka R; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Weymann A; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Szabó G; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Sonnenberg K; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Constantinescu AM; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Johnson SB; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Misiri J; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Takami M; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Miller RC; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Herman MG; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Asirvatham SJ; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Brons S; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Jäkel O; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Haberer T; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Debus J; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Durante M; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Bert C; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
  • Packer DL; From the Mayo Clinic Translational Interventional Electrophysiology Laboratory (H.I.L., S.B.J., J.M., M.T., S.J.A., D.L.P.) and Department of Radiation Oncology (R.C.M., M.G.H.), Mayo Clinic, Rochester, MN; Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany (
Circ Arrhythm Electrophysiol ; 8(2): 429-38, 2015 Apr.
Article em En | MEDLINE | ID: mdl-25609687
ABSTRACT

BACKGROUND:

Particle therapy, with heavy ions such as carbon-12 ((12)C), delivered to arrhythmogenic locations of the heart could be a promising new means for catheter-free ablation. As a first investigation, we tested the feasibility of in vivo atrioventricular node ablation, in Langendorff-perfused porcine hearts, using a scanned 12C beam. METHODS AND

RESULTS:

Intact hearts were explanted from 4 (30-40 kg) pigs and were perfused in a Langendorff organ bath. Computed tomographic scans (1 mm voxel and slice spacing) were acquired and (12)C ion beam treatment planning (optimal accelerator energies, beam positions, and particle numbers) for atrioventricular node ablation was conducted. Orthogonal x-rays with matching of 4 implanted clips were used for positioning. Ten Gray treatment plans were repeatedly administered, using pencil beam scanning. After delivery, positron emission tomography-computed tomographic scans for detection of ß(+) ((11)C) activity were obtained. A (12)C beam with a full width at half maximum of 10 mm was delivered to the atrioventricular node. Delivery of 130 Gy caused disturbance of atrioventricular conduction with transition into complete heart block after 160 Gy. Positron emission computed tomography demonstrated dose delivery into the intended area. Application did not induce arrhythmias. Macroscopic inspection did not reveal damage to myocardium. Immunostaining revealed strong γH2AX signals in the target region, whereas no γH2AX signals were detected in the unirradiated control heart.

CONCLUSIONS:

This is the first report of the application of a (12)C beam for ablation of cardiac tissue to treat arrhythmias. Catheter-free ablation using 12C beams is feasible and merits exploration in intact animal studies as an energy source for arrhythmia elimination.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Perfusão / Nó Atrioventricular / Técnicas de Ablação / Radioterapia com Íons Pesados Tipo de estudo: Evaluation_studies Idioma: En Revista: Circ Arrhythm Electrophysiol Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Perfusão / Nó Atrioventricular / Técnicas de Ablação / Radioterapia com Íons Pesados Tipo de estudo: Evaluation_studies Idioma: En Revista: Circ Arrhythm Electrophysiol Ano de publicação: 2015 Tipo de documento: Article