NSW Health and Medical Research

Radiation-ablation techniques to treat ventricular tachycardia and atrial fibrillation

University of Sydney

Grant:
  • Cardiovascular Early-Mid Career Researcher Grant
Organ System:
  • Cardiovascular
Date Funded:
  • 22 May, 2020
Chief Investigator/s:
  • Associate Professor Ricky O'Brien

Project summary

Developing new techniques to make radiation-based treatment for atrial fibrillation and ventricular tachycardia safer.

What is the issue for NSW?

Atrial Fibrillation and Ventricular Tachycardia occur when aberrant signals disrupt and override the natural electrical rhythm of the heart. For a majority of the >300,000 Australian’s with atrial fibrillation and ventricular tachycardia, treatment options are available and include catheter ablation to scar tissue and prevent aberrant signals. Unfortunately, survival rates are very low for patients that have exhausted all treatment options and are not good candidates for surgical ablation (e.g. failed catheter ablation or co-morbidities).

Radiation is a non-invasive way of causing ablative scarring that blocks these aberrant electrical signals. The potential for radiation-ablation has been demonstrated through a recent trial at Washington University, where improvements for 18 out of 19 ventricular tachycardia patients following radiation-ablation were shown to reduce the median number of ventricular tachycardia events from 119 to three. Due to the stunning results from this trial, radiation-ablation is receiving global attention due to the potential to treat patients with limited options remaining.

Directly irradiating the heart remains a very high-risk procedure with two of the 19 patients in the Washington University trial experiencing serious adverse events due to the radiation-ablation treatment alone, indicating that further improvements are urgently needed.

What does the research aim to do and how?

A/Professor O’Brien’s research is pioneering new techniques to make radiation-based treatment for atrial fibrillation and ventricular tachycardia safer. He aims to do this by performing research into better targeting the ablation site with radiation while steering radiation away from healthy structures in the heart. His initial focus is on the cohort of patients with very poor survival rates with the results from this initial cohort informing treatment decisions for the more general atrial fibrillation and ventricular tachycardia patient cohort.