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Research Article
Myung-Jin Cha
Seoul National University Hospital
Corresponding Author
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We tested the feasibility of pulmonary vein (PV) and left atrial (LA) posterior wall isolation using non-invasive stereotactic ablative body radiotherapy (SABR) and investigated pathological changes in irradiated lesions in a canine model. Seven male Mongrel dogs received single-fraction 33-Gy SABR. We designed the en-bloc circular target of total PVs and LA posterior wall to avoid the esophagus. The circular box lesion included the LA roof and ridge, low posterior wall, and posterior interatrial septum. At 6 weeks or 4 months post-SABR, electrical isolation of the SABR lesion was confirmed using LA posterior wall pacing, and histopathological review was performed. Electrical isolation of all PVs and the LA posterior wall was achieved in three of five dogs in the 4-month group. There was one target failure and one sudden death at 15 weeks. Although two dogs in the 6-week group failed to achieve electrical lesion isolation, the irradiated atrial myocardium showed diffuse hemorrhage with inflammatory cell infiltration. In successfully isolated 4-month model dogs, we observed transmural necrotic scarring with extensive fibrosis on irradiated atrial tissue. The findings suggest that this novel circular box-design radiotherapy technique using SABR could be applied to humans after further studies are conducted to confirm safety.
Keywords
atrial fibrillation, irradiation, pulmonary vein, cardiac radioablation, radiotherapy
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CURRENT STATUS: Under Review
Version 1
Posted 31 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 04 Mar, 2021
Reviews received
Received 04 Mar, 2021
Reviewers agreed
On 15 Feb, 2021
Reviews received
Received 05 Feb, 2021
Reviewers agreed
On 27 Jan, 2021
Reviewers invited
Invitations sent on 27 Jan, 2021
Editor assigned
On 27 Jan, 2021
Editor invited
On 29 Dec, 2020
Submission checks complete
On 28 Dec, 2020
First submitted
On 18 Dec, 2020
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A new preprint design is coming!
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Myung-Jin Cha
Seoul National University Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 31 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 04 Mar, 2021
Reviews received
Received 04 Mar, 2021
Reviewers agreed
On 15 Feb, 2021
Reviews received
Received 05 Feb, 2021
Reviewers agreed
On 27 Jan, 2021
Reviewers invited
Invitations sent on 27 Jan, 2021
Editor assigned
On 27 Jan, 2021
Editor invited
On 29 Dec, 2020
Submission checks complete
On 28 Dec, 2020
First submitted
On 18 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
We tested the feasibility of pulmonary vein (PV) and left atrial (LA) posterior wall isolation using non-invasive stereotactic ablative body radiotherapy (SABR) and investigated pathological changes in irradiated lesions in a canine model. Seven male Mongrel dogs received single-fraction 33-Gy SABR. We designed the en-bloc circular target of total PVs and LA posterior wall to avoid the esophagus. The circular box lesion included the LA roof and ridge, low posterior wall, and posterior interatrial septum. At 6 weeks or 4 months post-SABR, electrical isolation of the SABR lesion was confirmed using LA posterior wall pacing, and histopathological review was performed. Electrical isolation of all PVs and the LA posterior wall was achieved in three of five dogs in the 4-month group. There was one target failure and one sudden death at 15 weeks. Although two dogs in the 6-week group failed to achieve electrical lesion isolation, the irradiated atrial myocardium showed diffuse hemorrhage with inflammatory cell infiltration. In successfully isolated 4-month model dogs, we observed transmural necrotic scarring with extensive fibrosis on irradiated atrial tissue. The findings suggest that this novel circular box-design radiotherapy technique using SABR could be applied to humans after further studies are conducted to confirm safety.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
The full text of this article is available to read as a PDF.
This is a list of supplementary files associated with this preprint. Click to download.
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