1. Feasibility study on stereotactic radiotherapy for total pulmonary vein isolation in a canine model
- Author
-
Euijae Lee, So Yeon Park, Byoung Hyuck Kim, Seil Oh, Hak Jae Kim, Moo kang Kim, Jeong-Wook Seo, Myung Jin Cha, Ji Hyun Chang, and Hye sun Yoon
- Subjects
Male ,Science ,medicine.medical_treatment ,Cardiology ,030204 cardiovascular system & hematology ,Arrhythmias ,SABR volatility model ,Radiosurgery ,Sudden death ,Article ,Pulmonary vein ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Medical research ,Dogs ,Fibrosis ,medicine ,Animals ,030212 general & internal medicine ,Esophagus ,Multidisciplinary ,business.industry ,Translational research ,medicine.disease ,Atrial fibrillation ,Radiation therapy ,Experimental models of disease ,Disease Models, Animal ,medicine.anatomical_structure ,Preclinical research ,Pulmonary Veins ,Models, Animal ,Medicine ,Feasibility Studies ,medicine.symptom ,business ,Nuclear medicine ,Tomography, X-Ray Computed ,Interatrial septum - Abstract
We tested the feasibility of pulmonary vein (PV) and left atrial (LA) posterior wall isolation using non-invasive stereotactic ablative body radiotherapy (SABR) and investigated pathological changes in irradiated lesions in a canine model. Seven male Mongrel dogs received single-fraction 33-Gy SABR. We designed the en-bloc circular target of total PVs and LA posterior wall to avoid the esophagus. The circular box lesion included the LA roof and ridge, low posterior wall, and posterior interatrial septum. At 6 weeks or 4 months post-SABR, electrical isolation of the SABR lesion was confirmed using LA posterior wall pacing, and histopathological review was performed. Electrical isolation of all PVs and the LA posterior wall was achieved in three of five dogs in the 4-month group. There was one target failure and one sudden death at 15 weeks. Although two dogs in the 6-week group failed to achieve electrical lesion isolation, the irradiated atrial myocardium showed diffuse hemorrhage with inflammatory cell infiltration. In successfully isolated 4-month model dogs, we observed transmural necrotic scarring with extensive fibrosis on irradiated atrial tissue. The findings suggest that this novel circular box-design radiotherapy technique using SABR could be applied to humans after further studies are conducted to confirm safety.
- Published
- 2021