TY  - JOUR
AU  - Lehmann, H Immo
AU  - Richter, Daniel
AU  - Prokesch, Hannah
AU  - Graeff, Christian
AU  - Prall, Matthias
AU  - Simoniello, Palma
AU  - Fournier, Claudia
AU  - Bauer, Julia
AU  - Kaderka, Robert
AU  - Weymann, Alexander
AU  - Szabó, Gábor
AU  - Sonnenberg, Karin
AU  - Constantinescu, Anna M
AU  - Johnson, Susan B
AU  - Misiri, Juna
AU  - Takami, Mitsuru
AU  - Miller, Robert C
AU  - Herman, Michael G
AU  - Asirvatham, Samuel J
AU  - Brons, Stephan
AU  - Jäkel, Oliver
AU  - Haberer, Thomas
AU  - Debus, Jürgen
AU  - Durante, Marco
AU  - Bert, Christoph
AU  - Packer, Douglas L
TI  - 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.
JO  - Circulation / Arrhythmia and electrophysiology
VL  - 8
IS  - 2
SN  - 1941-3084
CY  - Philadelphia, Pa.
PB  - Lippincott, Williams & Wilkins
M1  - DKFZ-2017-03014
SP  - 429 - 438
PY  - 2015
AB  - 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.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 β(+) ((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.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.
KW  - Histones (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:25609687
DO  - DOI:10.1161/CIRCEP.114.002436
UR  - https://inrepo02.dkfz.de/record/126988
ER  -