Cardiologists and radiologists from the Hospital del Mar in Barcelona have used oncological radiotherapy to cure arrhythmia for the first time in Spain. This technique is applied to patients when they don’t respond to other treatments and could have to undergo a heart transplant.
Applying this technique to cure arrhythmia first originated in the US, where it has only been used in around 20 cases to date.
The head of the Cardiology Service at Hospital del Mar, Julio Martí, explained that the treatment consists in subjecting the dysfunctional area of the heart to a very high dose of radiation (25 grays in a single session, when 2 grays is generally used to treat cancer), to create scarring in the area and thus eliminate the arrhythmia.
He recognised the complexity of the technique, which requires a high level of specialisation of the professionals involved.
“We must work together. Firstly, the radiologists, who obtain the images; then the cardiologists, to indicate where the problem originates; and finally the radiotherapy oncologists who define the volume to be treated and how to do it”, explained the doctor.
The head of the Radiotherapy Oncology Service, Manel Algara, said that the technology used at the Hospital del Mar “allows us to define heart movement and breathing, and complete this intervention without damaging other organs and structures close to the heart”.
According to Algara, this intervention is short, only 30 minutes, compared to over two hours needed for ablation with regular techniques, and it is supervised by a cardiologist to deal with any complications.
Patients who can benefit from this new technique have epicardial pathology, i.e., where the arrhythmia originates in the external area of the heart muscle.
Also patients with ischemic pathologies where the injury is in the external area of the heart, patients with Chagas heart disease, or others with an ischemic pathology in scar phase affecting the epicardium that cannot be accessed from inside the body.
“They are cases in which this is the most suitable technique” as, according to Martí, “the fundamental advantage is that the area to be treated is difficult to access using common catheter techniques. With it, we can perfectly define the volume and area to be treated”.
The first patient treated with this technique is a 64 year old man suffering a heart pathology called arrhythmogenic dysplasia of the right ventricle, where the heart muscle is replaced by adipose tissue where ventricular arrhythmias are more easily produced.
In this case, the patient had already unsuccessfully underwent three ablations to try to solve the problem, the last in October.
The patient had been fitted with a defibrillator to prevent cardiac arrest, but the device was no longer useful due to the damage the illness had caused in the heart muscle.
Cardiologists operated on him on 21 December and, since then, his arrhythmias have disappeared completely, with no side effects from the radiation.
However, doctors have acknowledged that response to radiation is slower with this technique and the positive effects may take longer to show.
This is the second case in the world with this pathology treated with radiotherapy.
Arrhythmogenic dysplasia of the right ventricle is a rare disease with unknown causes and was originally described just 42 years ago.
Doctors do not know the exact incidence of this disease, but it is more common in men and more widespread in athletes.