title: Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams.
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.
authors.affiliation: Mayo Clinic Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN, USA.
authors.forename: H Immo
authors.initials: HI
authors.lastname: Lehmann
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Graeff
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Palma
authors.initials: P
authors.lastname: Simoniello
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Constantinescu
authors.affiliation: Mayo Clinic Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Takami
authors.affiliation: Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lugenbiel
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.|Department of Radiation Oncology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Richter
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Eichhorn
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Prall
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Kaderka
authors.affiliation: Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Dresden, Germany.
authors.forename: Fine
authors.initials: F
authors.lastname: Fiedler
authors.affiliation: Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Dresden, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Helmbrecht
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Fournier
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Erbeldinger
authors.affiliation: Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Ann-Kathrin
authors.initials: AK
authors.lastname: Rahm
authors.affiliation: Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Rivinius
authors.affiliation: Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Dierk
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Johnson
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.
authors.forename: Kay D
authors.initials: KD
authors.lastname: Parker
authors.affiliation: Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.affiliation: Mayo Clinic Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN, USA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.|Department of Radiation Oncology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bert
authors.affiliation: Department of Biophysics GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.|Trento Institute for Fundamentals Physics Applications (TIFPA-INFN), University of Trento, Trento, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Durante
authors.affiliation: Mayo Clinic Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000528:radiation effects; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D049268:Positron-Emission Tomography; D011882:Radiotherapy, High-Energy / Q000379:methods*; D034421:Sus scrofa