vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-2021-E-44-50vestar-988Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLEExperimental use of stereotactic radiosurgery for non-invasive interventions in arrhythmologyExperimental use of stereotactic radiosurgery for non-invasive interventions in arrhythmologyVaskovskiyV. А.VaskovskiyV. A.

 Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

vvaskov03@mail.ruTaymasovaI. А.TaymasovaI. A.

 Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

KalininD. V.KalininD. V.

 Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

AntipinaN. А.AntipinaN. A.

 Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

NikolaevaА. А.NikolaevaA. A.

 Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

SmirnovG. Y.SmirnovG. Y.

 Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

GolanovА. V.GolanovA. V.

 Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

PotapovА. А.PotapovA. A.

 Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

Russia, Moscow, 16 Four Tverskaya-Yamskaya str. 

RevishviliА. Sh.RevishviliA. Sh.

 Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

Russia, Moscow, 27 Bolshaya Serpukhovskaya str 

A.V.Vishnevsky National Medical Research Center of SurgeryРоссияA.V.Vishnevsky National Medical Research Center of SurgeryRussian FederationN.N.Burdenko National Medical Research Center of NeurosurgeryРоссияN.N.Burdenko National Medical Research Center of NeurosurgeryRussian Federation202126102021280E4450Copyright © Vaskovskiy V.А., Taymasova I.А., Kalinin D.V., Antipina N.А., Nikolaeva А.А., Smirnov G.Y., Golanov А.V., Potapov А.А., Revishvili А.S., 20212021Vaskovskiy V.А., Taymasova I.А., Kalinin D.V., Antipina N.А., Nikolaeva А.А., Smirnov G.Y., Golanov А.V., Potapov А.А., Revishvili А.S.Vaskovskiy V.A., Taymasova I.A., Kalinin D.V., Antipina N.A., Nikolaeva A.A., Smirnov G.Y., Golanov A.V., Potapov A.A., Revishvili A.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/988

Purpose. The experimental study aimed to study the effects of stereotaxic radioablation of various doses on the myocardium of the atria, ventricles and atrioventricular (AV) node in the long term (up to 6 months); as well as assessment of collateral damage during radioablation.Methods. The study comprised 4 domestic pigs. The animals were 10-12 weeks old, the average weight was 30±2.7 kg. A linear accelerator was used for the experiment. Each animal underwent radiation exposure in different areas: 1st animal - AV node (dose 35 Gy), 2nd animal - AV node and the apex of the left ventricle (LV) (dose 40/35 Gy, respectively), 3rd animal - pulmonary veins (PV) and left atrium (dose 30 Gy), 4th - AV node and LV free wall (dose 45/40 Gy). Under intravenous sedation with hemodynamic monitoring, contrast-based CT of the heart was performed to assess the degree of displacement of the heart chambers in one respiratory and cardiac cycle and to assess the anatomy of the chambers of the heart and adjacent organs. The allocation and the contouring of the target zones were carried out in three projections: axial, frontal and sagittal. For electrocardiographic control, a loop recorder was implanted in each animal. The average exposure time was 11±7 minutes. After a follow-up period, morphological examination of the autopsy material was performed.Results. The average follow-up period after ablation was 134.75±77.34 days. The electrophysiological effect of the ablation was achieved in cases of complete AV-block development. This effect was developed in 2 out of 3 animals, where AV-node was exposed: 2nd animal - 40 Gy on 108th day of observation and 4th animal - 45 Gy on 21st day of observation. No cardiac tachyarrhythmia was recorded in the animals. The results of myocardium macro- and microscopic examination showed significant changes in the target zones. These areas had precise but uneven damage boundaries, which were within the planned ones (conformal exposure with a high degree of precision). The transmural nature of the changes was noted as well. Massive fields of fibrous tissue of various degrees of maturity (with a predominance of subepicardial localization) with focal hemorrhages of various ages and granulations were detected, which were surrounded by cardiomyocytes with coagulated and vacuolated cytoplasm.Conclusion. The use of non-invasive stereotactic treatment of tachyarrhythmias has high prospects in modern electrophysiology as an alternative ablation method.

 

 

Purpose

Purpose. The experimental study aimed to study the effects of stereotaxic radioablation of various doses on the myocardium of the atria, ventricles and atrioventricular (AV) node in the long term (up to 6 months); as well as assessment of collateral damage during radioablation.Methods. The study comprised 4 domestic pigs. The animals were 10-12 weeks old, the average weight was 30±2.7 kg. A linear accelerator was used for the experiment. Each animal underwent radiation exposure in different areas: 1st animal - AV node (dose 35 Gy), 2nd animal - AV node and the apex of the left ventricle (LV) (dose 40/35 Gy, respectively), 3rd animal - pulmonary veins (PV) and left atrium (dose 30 Gy), 4th - AV node and LV free wall (dose 45/40 Gy). Under intravenous sedation with hemodynamic monitoring, contrast-based CT of the heart was performed to assess the degree of displacement of the heart chambers in one respiratory and cardiac cycle and to assess the anatomy of the chambers of the heart and adjacent organs. The allocation and the contouring of the target zones were carried out in three projections: axial, frontal and sagittal. For electrocardiographic control, a loop recorder was implanted in each animal. The average exposure time was 11±7 minutes. After a follow-up period, morphological examination of the autopsy material was performed.Results. The average follow-up period after ablation was 134.75±77.34 days. The electrophysiological effect of the ablation was achieved in cases of complete AV-block development. This effect was developed in 2 out of 3 animals, where AV-node was exposed: 2nd animal - 40 Gy on 108th day of observation and 4th animal - 45 Gy on 21st day of observation. No cardiac tachyarrhythmia was recorded in the animals. The results of myocardium macro- and microscopic examination showed significant changes in the target zones. These areas had precise but uneven damage boundaries, which were within the planned ones (conformal exposure with a high degree of precision). The transmural nature of the changes was noted as well. Massive fields of fibrous tissue of various degrees of maturity (with a predominance of subepicardial localization) with focal hemorrhages of various ages and granulations were detected, which were surrounded by cardiomyocytes with coagulated and vacuolated cytoplasm.Conclusion. The use of non-invasive stereotactic treatment of tachyarrhythmias has high prospects in modern electrophysiology as an alternative ablation method.

 

 

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The authors declare that there are no conflicts of interest present.