Swine Atrioventricular Node Ablation Using Stereotactic Radiosurgery: Methods and In Vivo Feasibility Investigation for Catheter-Free Ablation of Cardiac Arrhythmias

Journal of the American Heart Association
Marwan M RefaatBassem Youssef

Abstract

Linear accelerator-based stereotactic radiosurgery delivered to cardiac arrhythmogenic foci could be a promising catheter-free ablation modality. We tested the feasibility of in vivo atrioventricular (AV) node ablation in swine using stereotactic radiosurgery. Five Large White breed swine (weight 40-75 kg; 4 females) were studied. Single-chamber St Jude pacemakers were implanted in each pig. The pigs were placed under general anesthesia, and coronary/cardiac computed tomography simulation scans were performed to localize the AV node. Cone beam computed tomography was used for target positioning. Stereotactic radiosurgery doses ranging from 35 to 40 Gy were delivered by a linear accelerator to the AV node, and the pigs were followed up with weekly pacemaker interrogations to observe for potential electrocardiographic changes. Once changes were observed, the pigs were euthanized, and pathology specimens of various tissues, including the AV node and tissues surrounding the AV node, were taken to study the effects of radiation. All 5 pigs had disturbances of AV conduction with progressive transition into complete heart block. Macroscopic inspection did not reveal damage to the myocardium, and pigs had preserved systolic function on...Continue Reading

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Citations

Jul 21, 2020·Arrhythmia & Electrophysiology Review·Chen WeiPaul C Zei
May 15, 2020·La Radiologia medica·Alba FiorentinoMassimo Grimaldi
Oct 6, 2020·Cardiology in Review·Ammar M AtharJason Jacobson
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Sep 30, 2021·Journal of Cardiovascular Electrophysiology·Chen WeiPaul C Zei
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Methods Mentioned

BETA
biopsy
biopsies
light microscopy

Clinical Trials Mentioned

NCT02919618
NCT02661048

Software Mentioned

Siemens Syngo
CyberHeart
Panther

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