Heart Center Leipzig: New therapy method for cardiac arrhythmias
Heart Center Leipzig and Leipzig University Hospital have successfully applied a new treatment method to a patient with a potentially life-threatening cardiac arrhythmia. In what is known as "stereotactic arrhythmia radioablation" (STAR), the affected tissue is treated in a state-of-the-art procedure using high-dose radiation with maximum precision in order to reduce the electrical excitability of this area. The two clinics intend to offer this new procedure jointly in the future.
Patients with the most serious heart conditions, such as those that occur after a heart attack, often suffer from palpitations from the ventricles (ventricular tachycardia) - a potentially life-threatening cardiac arrhythmia. Normally, catheter-assisted ablation is performed here, in which the affected areas of tissue in the heart are specifically obliterated. However, in some patients these areas are difficult to access or the ablation does not have a sufficient effect.
Stereotactic arrhythmia radioablation (STAR) can overcome precisely these challenges. This is a non-invasive, highly precise procedure in which the affected scar areas of the heart are treated very precisely and once with high-dose radiotherapy. This changes the electrical excitability of the heart and thus minimizes the risk of further potentially life-threatening arrhythmias.
The therapy is possible thanks to the close collaboration between the Department of Rhythmology at the Leipzig Heart Center, headed by PD Dr. med. Kerstin Bode and the Clinic and Polyclinic for Radiotherapy at Leipzig University Hospital under the direction of Prof. Dr. Dr. Nils Nicolay.
For which patient groups is STAR suitable?
STAR therapy is particularly suitable for two groups of patients:
- Patients with severe structural heart disease in whom drug therapy and previous ablations have not had the desired effect.
- Patients with one or two mechanical heart valves for whom catheter-based treatment is not feasible due to technical limitations
Technology and challenges of STAR therapy
In contrast to static organs such as the intestine or liver, the beating heart is constantly moving - one of the major challenges when planning and carrying out radiotherapy. Dr. Sotirios Nedios from the Heart Center and Dr. Franziska Nägler from the Polyclinic for Radiotherapy were in charge of the elaborate preparations.
"In order to localize the affected areas as precisely as possible, we fuse the image data from the CT scan with electrophysiological mapping data that was created in advance. This allows us to identify and mark the disease-causing areas in the imaging with millimeter precision. The aim is to affect the surrounding tissue as little as possible during radiotherapy."
- PD Dr. med. Kerstin Bode, Chief Physician of the Department of Rhythmology | Heart Center Leipzig
Accuracy in the millimeter range
"The irradiation is carried out using a so-called linear accelerator of the latest generation. This allows us to achieve high-precision control of the radiation dose with an accuracy in the millimeter range," explains Prof. Nils Nicolay. "Thanks to the special design of the device, we are able to safely deliver the necessary high dose to even the smallest radiation areas. In addition, state-of-the-art imaging systems in the treatment room allow us to monitor the movement of the heart and lungs in real time and correct the smallest deviations immediately during treatment." The treatment is completely painless for the patient and can be carried out while the patient is fully conscious.
The first patient's cardiac arrhythmia was significantly reduced after just a few weeks. This success - particularly because all previous therapies had failed to bring any improvement - encouraged Heart Center Leipzig and Leipzig University Hospital to continue working closely together to treat these dangerous arrhythmias. The aim is to offer patients this promising new therapy method by combining specialist expertise and state-of-the-art technology and to be able to accompany them seamlessly during their treatment.
New quality of life
The patient, 37-year-old Daniel Hrivnak, was in excellent health when an initially undetected myocarditis severely damaged his heart. He collapsed in the swimming pool with life-threatening cardiac arrhythmia and had to be resuscitated. Since then, the native of Quedlinburg has struggled with recurring cardiac arrhythmias. After drug therapy and several ablations, which were unable to eliminate the palpitations, he was advised to undergo radiotherapy. "Last year, just in time for Christmas, I was given a new quality of life - from a bedridden patient I am slowly becoming a person fit for everyday life again. Since the operation, I haven't had a single life-threatening cardiac arrhythmia. My family and I are infinitely grateful to the doctors at Heart Center Leipzig and Leipzig University Hospital," says Hrivnak.
