From oncological radiotherapy a new cure for the ‘crazy heart’. In patients with atrial fibrillation, “a single 10-minute session, painless”, promises to “correct the cardiac electrical defect from the outside, with high doses of radiation, without side effects or hospitalization”. This is the approach tested by the Irccs of Negrar, in the province of Verona, where Giulio Molon, director of the Cardiology complex operating unit, and Filippo Alongi, director of the Department of advanced oncological radiotherapy and full professor at the University of Brescia, two months ago, they enrolled and treated the first two patients suffering from recurrence of atrial fibrillation, using radiotherapy traditionally used for the treatment of tumours. “An innovative treatment” carried out “as part of the Trast-Af clinical trial – the Veneto center informs – which envisages the enrollment of 15 patients, and which could in the near future be a therapeutic alternative to fibrillation ablation surgery atrial”.
“Atrial fibrillation affects 10 million people in Europe and 800 thousand in Italy – explains Molon, study coordinator of the Trast-Af study – It is the most common cardiac arrhythmia among the general population, the incidence of which is proportional to the increase in age, and is one of the main causes of stroke and heart failure: it takes away 25% of the effectiveness of the heart’s ‘pump’, causing tiredness, shortness of breath and lack of strength”. Atrial fibrillation patients currently undergo a procedure that involves introducing a catheter through the femoral artery, a note recalls. The tip of the catheter delivers radiofrequency and eliminates the tissue parts responsible for arrhythmias, located in a delicate area where the pulmonary veins enter the left atrium. “A non-surgical, but still invasive, time-consuming and uncomfortable procedure for the patient, requiring hospitalization and sedation,” notes Molon.
“Radiotherapy, on the other hand – he specifies – by directing the beam of ionizing radiation at high doses against the cells responsible for the arrhythmia, obtains the same healing of the area, interrupting the short circuit that causes fibrillation, but it is not invasive, it is painless and the treatment it is carried out in a single session lasting a maximum of 10 minutes. After which the patient can safely go home”. At the moment “the two patients on whom we have intervened have not reported significant side effects – reports Niccolò Giaj Levra, specialist in oncological radiotherapy and referent for cardiological treatments at the Department of advanced oncological radiotherapy of the Irccs Negrar – These initial results lead us to continue the experimentation with the enrollment of other patients, to better define the efficacy of the ablative radiotherapy treatment on the heart and the benefits in terms of quality of life as well as the implementation of telemedicine”.
The study underway by the Irccs of Negrar, in fact, also exploits the advantages of telemedicine. “In the months following the treatment – highlights Giaj Levra – the patients carried out close monitoring with repeated electrocardiograms from the comfort of their home, as well as compiling an electronic clinical diary transmitted via the web. We have equipped the patients with a new device which allows, simply by placing two fingers on a sensor, to obtain a rapid tracing of the heartbeat. This test is instantly transmitted to the cardiologist who can verify the proper functioning of the heart at any time. The goal is to assist the patient on an ongoing basis even at home, trying to restrict access to the facility”.
“The Department of Advanced Oncological Radiotherapy of the Irccs Negrar boasts one of the most advanced technological equipment at an international level – says Alongi – The level of precision of the treatment guaranteed by linear accelerators allows us to irradiate not only primary or metastatic tumors, without damaging surrounding tissues, but also other anomalous tissues, such as those that trigger atrial and ventricular fibrillation, safeguarding the neighboring organs as much as possible. The affected cells undergo such damage as to induce the interruption of cardiac arrhythmia”.
“Even if more robust data will be needed – concludes Molon – the albeit small percentage of patients involved in our study will be able to give precise indications for the treatment of a heart rhythm abnormality that is very frequent in our patients, thus opening up a new perspective which over time will be able to give better and better results in the treatment of atrial fibrillation”.
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