External ablation of ischemic ventricular tachycardia in an animal infarct model using a scanned proton beam

• Applicant: Dr. Stephan Hohmann
• Subject Area: Cardiology, Angiology
• Term: from 2017 to 2019
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 380200397

Patients with ischemic cardiomyopathy after myocardial infarction are at high risk for developing life-threatening ventricular arrhythmias. Every year there are over 4 million cases of sudden cardiac death worldwide, most of which are caused by ventricular arrhythmias. In addition to implantation of implantable cardioverters/defibrillators, catheter ablation of ventricular tachycardia (VT) has increasingly been adopted in recent years. Arrhythmogenic areas in the ventricular myocardium are ablated using radio-frequency current. Although being established in everyday clinical practice, this method currently results in long term freedom from VT in no more than 50% of cases. One reason for this limited success lies in the difficulty of homogenizing the arrhythmogenic infarct border zone in its entire intramural extent.Preliminary work by the group of Prof. Packer and others has shown that myocardial ablation is possible using radiotherapeutic approaches. Due to their physical properties, proton beams are particularly suitable for targeted energy application while protecting surrounding organs at risk. Proton therapy is therefore increasingly used in radio-oncology. In this project, we will investigate catheter-free ablation of ventricular tachycardias after myocardial infarction using proton beam therapy in vivo. After developing methods for treatment planning in an established swine model for VT after myocardial infarction, proton beam therapy is applied. Treatment effects are then analyzed by electrophysiological studies and multi-modal imaging in the intact animal before the lesions are examined histologically. Catheter-free ablation has the potential to bring about a paradigm shift in the clinical treatment of ventricular arrhythmia.

• DFG Programme: Research Fellowships
• International Connection: USA
• Host: Professor Dr. Douglas L. Packer