The effect of ionizing radiation through cardiac stereotactic body radiation therapy on myocardial tissue for refractory ventricular arrhythmias: A review

被引:12
|
作者
Whitaker, John [1 ,2 ,3 ]
Zei, Paul C. [1 ,2 ]
Ahmad, Shahreen [3 ,4 ]
Niederer, Steven [3 ]
O'Neill, Mark [3 ]
Rinaldi, Christopher A. [3 ]
机构
[1] Brigham & Womens Hosp, Boston, MA 02115 USA
[2] Harvard Med Sch, Boston, MA 02115 USA
[3] Kings Coll London, Sch Biomed Engn & Imaging Sci, London, England
[4] Guys & St Thomass NHS Fdn Trust, London, England
来源
FRONTIERS IN CARDIOVASCULAR MEDICINE | 2022年 / 9卷
基金
英国惠康基金;
关键词
cardiac stereotactic body radiation therapy; ventricular tachycardia; cellular response; cardiomyopathy; ablation electrophysiology; CATHETER-FREE ABLATION; BETA-RADIATION; RADIOSURGERY; RADIOTHERAPY; HEARTS; CREATION; LESIONS;
D O I
10.3389/fcvm.2022.989886
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiac stereotactic body radiation therapy (cSBRT) is a non-invasive treatment modality that has been recently reported as an effective treatment for ventricular arrhythmias refractory to medical therapy and catheter ablation. The approach leverages tools developed and refined in radiation oncology, where experience has been accumulated in the treatment of a wide variety of malignant conditions. However, important differences exist between rapidly dividing malignant tumor cells and fully differentiated myocytes in pathologically remodeled ventricular myocardium, which represent the respective radiation targets. Despite its initial success, little is known about the radiobiology of the anti-arrhythmic effect cSBRT. Pre-clinical data indicates a late fibrotic effect of that appears between 3 and 4 months following cSBRT, which may result in conduction slowing and block. However, there is clear clinical evidence of an anti-arrhythmic effect of cSBRT that precedes the appearance of radiation induced fibrosis for which the mechanism is unclear. In addition, the data to date suggests that even the late anti-arrhythmic effect of cSBRT is not fully attributable to radiation.-induced fibrosis. Pre-clinical data has identified upregulation of proteins expected to result in both increased cell-to-cell coupling and excitability in the early post cSBRT period and demonstrated an associated increase in myocardial conduction velocity. These observations indicate a complex response to radiotherapy and highlight the lack of clarity regarding the different stages of the anti-arrhythmic mechanism of cSBRT. It may be speculated that in the future cSBRT therapy could be planned to deliver both early and late radiation effects titrated to optimize the combined anti-arrhythmic efficacy of the treatment. In addition to these outstanding mechanistic questions, the optimal patient selection, radiation modality, radiation dose and treatment planning strategy are currently being investigated. In this review, we consider the structural and functional effect of radiation on myocardium and the possible anti-arrhythmic mechanisms of cSBRT. Review of the published data highlights the exciting prospects for the development of knowledge and understanding in this area in which so many outstanding questions exist.
引用
收藏
页数:12
相关论文
共 50 条
  • [1] Non-invasive stereotactic body radiation therapy for refractory ventricular arrhythmias: an institutional experience
    Chin, Robert
    Hayase, Justin
    Hu, Peng
    Cao, Minsong
    Deng, Jie
    Ajijola, Olujimi
    Do, Duc
    Vaseghi, Marmar
    Buch, Eric
    Khakpour, Houman
    Fujimura, Osamu
    Krokhaleva, Yuliya
    Macias, Carlos
    Sorg, Julie
    Gima, Jean
    Pavez, Geraldine
    Boyle, Noel G.
    Steinberg, Michael
    Shivkumar, Kalyanam
    Bradfield, Jason S.
    JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2021, 61 (03) : 535 - 543
  • [2] Non-invasive stereotactic body radiation therapy for refractory ventricular arrhythmias: an institutional experience
    Robert Chin
    Justin Hayase
    Peng Hu
    Minsong Cao
    Jie Deng
    Olujimi Ajijola
    Duc Do
    Marmar Vaseghi
    Eric Buch
    Houman Khakpour
    Osamu Fujimura
    Yuliya Krokhaleva
    Carlos Macias
    Julie Sorg
    Jean Gima
    Geraldine Pavez
    Noel G. Boyle
    Michael Steinberg
    Kalyanam Shivkumar
    Jason S. Bradfield
    Journal of Interventional Cardiac Electrophysiology, 2021, 61 : 535 - 543
  • [3] Cardiac stereotactic body radiation therapy for ventricular tachycardia: Current experience and technical gaps
    Wei, Chen
    Qian, Pierre C.
    Boeck, Michelle
    Bredfeldt, Jeremy S.
    Blankstein, Ron
    Tedrow, Usha B.
    Mak, Raymond
    Zei, Paul C.
    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2021, 32 (11) : 2901 - 2914
  • [4] Stereotactic body radiation therapy for refractory ventricular tachycardia secondary to cardiac lipoma: A case report
    Zeng, Li-Jun
    Huang, Li-Hong
    Tan, Hong
    Zhang, Hou-Cai
    Mei, Ju
    Shi, Hai-Feng
    Jiang, Chen-Yang
    Tan, Chen
    Zheng, Jian-Wei
    Liu, Xing-Peng
    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 2019, 42 (09): : 1276 - 1279
  • [5] Case report: Stereotactic body radiation therapy with 12 Gy for silencing refractory ventricular tachycardia
    Huang, Shan-Hui
    Wu, Yen-Wen
    Shueng, Pei-Wei
    Wang, Shan-Ying
    Tsai, Meng-Chieh
    Liu, Yuan-Hung
    Chuang, Wen-Po
    Lin, Heng-Hsu
    Tien, Hui-Ju
    Yeh, Hsin-Pei
    Hsieh, Chen-Hsi
    FRONTIERS IN CARDIOVASCULAR MEDICINE, 2022, 9
  • [6] First Asian population study of stereotactic body radiation therapy for ventricular arrhythmias
    Ho, Li-Ting
    Chen, Jenny Ling-Yu
    Chan, Hsing-Min
    Huang, Yu-Cheng
    Su, Mao-Yuan
    Kuo, Sung-Hsin
    Chang, Yeun-Chung
    Lin, Jiunn-Lee
    Chen, Wen-Jone
    Lee, Wen-Jeng
    Lin, Lian-Yu
    SCIENTIFIC REPORTS, 2021, 11 (01)
  • [7] One-year mortality and causes of death after stereotactic radiation therapy for refractory ventricular arrhythmias: A systematic review and pooled analysis
    Benali, Karim
    Zei, Paul C.
    Lloyd, Michael
    Kautzner, Josef
    Guenancia, Charles
    Ninni, Sandro
    Rigal, Louis
    Simon, Antoine
    Bellec, Julien
    Vlachos, Konstantinos
    Sacher, Frederic
    Hammache, Nefissa
    Sellal, Jean-Marc
    de Crevoisier, Renaud
    Da Costa, Antoine
    Martins, Raphael
    TRENDS IN CARDIOVASCULAR MEDICINE, 2024, 34 (07) : 488 - 496
  • [8] Review and Uses of Stereotactic Body Radiation Therapy for Oligometastases
    Alongi, Filippo
    Arcangeli, Stefano
    Filippi, Andrea Riccardo
    Ricardi, Umberto
    Scorsetti, Marta
    ONCOLOGIST, 2012, 17 (08) : 1100 - 1107
  • [9] A series of case reports on stereotactic body radiation for the treatment of refractory ventricular tachycardia
    Tamara, Jarm
    Kristof, Knap
    Bor, Antolic
    Bostjan, Berlot
    Rihard, Hudej
    Aljasa, Jenko
    Ajra, Secerov Ermenc
    Jasna, But-Hadzic
    Ivica, Ratosa
    ONKOLOGIJA, 2023, 27 (02) : 56 - 60
  • [10] Early Tissue Effects of Stereotactic Body Radiation Therapy for Spinal Metastases
    Steverink, Jasper G.
    Willems, Stefan M.
    Philippens, Marielle E. P.
    Kasperts, Nicolien
    Eppinga, Wietse S. C.
    Versteeg, Anne L.
    van der Velden, Joanne M.
    Faruqi, Salman
    Sahgal, Arjun
    Verlaan, Jorrit-Jan
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2018, 100 (05): : 1254 - 1258