In this interview with MEDICA-tradefair.com, Prof. Hendrik Bonnemeier and Prof. Jürgen Dunst talk about treating a patient with severe, treatment-refractory cardiac arrhythmia using high-precision radiation of the myocardium, they explain the backdrop and describe the new perspectives that open up as a result of this approach.
Prof. Bonnemeier, can you describe the clinical picture of the patient you recently treated for his heart arrhythmia?
Prof. Hendrik Bonnemeier: In the past, the patient had suffered from ischemic cardiomyopathy, a condition where portions of a ventricle experience a lack of blood supply due to narrowed arteries. This caused heterogeneous scarring in the anterior left ventricle. Due to the low cardiac output, the patient received an implantable defibrillator and had to take a maximum dose of antiarrhythmic drugs. Yet despite this treatment, the patient suffered shocks from the defibrillator every day, which drastically impacted his quality of life and that of his family members.
Why did you choose this particular treatment?
Bonnemeier: Cardiac arrhythmia is caused by impulses that uncontrollably loop around scar tissue in the ventricle, a so-called reentry (see devices for heart circulation diagnostics in the catalogue of MEDICA 2018). This palpitation causes circulatory instability. The typical weapon of choice is catheter ablation of the myocardial tissue in the ventricle to stop this from happening. In this case, however, the site of the reentry could not be accessed for catheter ablation due to its position. It is impossible to ablate cardiac muscle cells that are located this deep inside the tissue (find more information about vascular surgical instruments in the catalogue of MEDICA 2018).
After a positive vote by the ethics committee, we chose high-precision radiation as a personalized treatment attempt. My team and I collaborated with the team of Prof. Jürgen Dunst to perform the treatment.