Examining Hearts Containing Left Ventricular Assist Devices at Necropsy

Roberts, William C.; Ather, Nuvaira; Guileyardo, Joseph M.

doi:10.1016/j.amjcard.2019.10.013

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…The patient described in our study was not considered for epicardial ablation due to anatomical constraints, nor received a left ventricle assist device, both of which can lead to significant scarring, hemorrhage, and edema ( 16 , 17 ) reported by previous authors ( 6 , 7 ). The lack of visible necrosis could also be associated with the modality of heart rhythm cessation.…”

Section: Discussionmentioning

confidence: 99%

Histopathological Examination of an Explanted Heart in a Long-Term Responder to Cardiac Stereotactic Body Radiotherapy (STereotactic Arrhythmia Radioablation)

Miszczyk

Sajdok

Nożyński

et al. 2022

Front. Cardiovasc. Med.

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Cardiac stereotactic body radiotherapy is an emerging treatment method for recurrent ventricular tachycardia refractory to invasive treatment methods. The single-fraction delivery of 25 Gy was assumed to produce fibrosis, similar to a post-radiofrequency ablation scar. However, the dynamics of clinical response and recent preclinical findings suggest a possible different mechanism. The data on histopathological presentation of post-radiotherapy hearts is scarce, and the authors provide significantly different conclusions. In this article, we present unique data on histopathological examination of a heart explanted from a patient who had a persistent anti-arrhythmic response that lasted almost a year, until a heart failure exacerbation caused a necessity of a heart transplant. Despite a complete treatment response, there was no homogenous transmural fibrosis in the irradiated region, and the overall presentation of the heart was similar to other transplanted hearts of patients with advanced heart failure. In conclusion, our findings support the theorem of functional changes as a source of the anti-arrhythmic mechanism of radiotherapy and show that durable treatment response can be achieved in absence of transmural fibrosis of the irradiated myocardium.

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