LKH Graz: Using radiation to combat heart arrhythmias

“There are cases of arrhythmia that cannot be controlled by maximum medication or local ablation procedures,” says Thomas Brunner, head of the University Clinic for Radiotherapy and Radiation Oncology.

The motivation system is being “reprogrammed”.

Stereotactic radiotherapy (STAR) is the name of a procedure that offers hope to people with untreatable ventricular arrhythmias. Similar to cancer treatment, but with a much higher dose, the specific area of ​​the heart muscle responsible for the arrhythmia is treated.

“Precise irradiation reprograms the electrical conduction system in the heart,” explains Brunner. The radiation therapists in Graz work closely with the clinical department of cardiology to treat these patients. The image-guided procedure takes only a few minutes – but requires careful planning and extreme precision in an interdisciplinary team.

When other treatment options are not effective

Arrhythmias can be dangerous if the heart is out of rhythm for a long time and its pumping function is impaired as a result. “Malignant” arrhythmias include ventricular tachycardia, where the left chamber of the heart (ventricle) beats irregularly and too quickly – they arise from secondary areas of the heart muscle. Treatment options include medications, the insertion of a defibrillator, or catheter ablation.

The new treatment method is used when conventional methods have not worked. “That’s exactly where high-precision radiation comes into play,” explains Tanja Langsenleiner, who is part of the newly established STAR team at the University Hospital for Radiotherapy – Radiation Oncology, which integrates colleagues from the Clinical Department of Cardiology and is the first team of experts in Austria for the new form of therapy. The method is relatively new and is only performed in a few clinics in Germany. It has already been used around 500 times worldwide.

Not suitable for all patients

Not all patients are suitable for this special radiotherapy. Exclusion criteria include the area to be irradiated being too close to the esophagus, which could be damaged by the high dose. According to the forecast, between five and ten affected people throughout Austria will benefit from the new treatment, which has so far mainly been used to treat lung cancer. If the procedure is successful, the arrhythmia is eliminated – according to previous studies, this rate is around 80 percent. Three patients have been treated in Graz so far.

Since the beginning of the year, the STAR team has been a member of the STOPSTORM project, which is funded by the European Union to the tune of two million euros, says Brunner. The acronym stands for “Standardized Treatment and Outcome Platform for Stereotactic Therapy of Arrhythmias Returning from a Multidisciplinary Consortium.” As part of this large-scale international project, the treatments of Graz patients are also being scientifically supported.