Arrhythmias & electrophysiologyMechanistic study
Cardiac radiotherapy transiently alters left ventricular electrical properties and induces cardiomyocyte-specific ventricular substrate changes in heart failure
- Mechanistic study
- single patient
- serial high-density electroanatomic mapping
- tissue sampling
Authors' conclusion
Our study supports the notion of transiently altered cardiac conduction potentially related to structural and functional cellular changes as an underlying mechanism of cRA in patients with ventricular tachycardia.
Study context
- Population
- Patient with a left ventricular assist device and repeated VT episodes despite several catheter-based endocardial radio-frequency ablation attemptssingle patient with LV assist device
- Comparison
- Irradiated region vs Borderzone
Main finding
As reported in the abstract
LV septal electrical and cellular substrate changes after cardiac radioablation (cRA) (local voltage, local activation time, sodium channel expression, mitochondrial density) · 2- and 4-month post-cRA
- Local voltage altered in the irradiated region of the LV septum during follow-up
- No change of local voltage in the control (borderzone) region
- Local activation time significantly shortened at 2-month post-cRA, reversible at 4-month post-cRA
- Increased expression of voltage-dependent sodium channels in the irradiated region vs borderzone; Connexin43 and transforming growth factor beta unchanged (4-month post-cRA)
- Mitochondrial density decreased in the irradiated region vs borderzone
Original publication
Cardiac radiotherapy transiently alters left ventricular electrical properties and induces cardiomyocyte-specific ventricular substrate changes in heart failure. Europace. Published 9 January 2024. doi:10.1093/europace/euae005
Summarised from the published abstract; every number is checked against it