Heart Institute performs game-changing procedure
Non-invasive technique employs equipment used to treat cancer
When the treatment was done, the patient looked confused. “Is that it?” he asked Dr. Calum Redpath.
That was it. The potentially life-saving treatment for a deadly heart ailment was completed in a painless, non-invasive session. The patient was free to go.
Performed by a team of doctors from the University of Ottawa Heart Institute in partnership with doctors at The Ottawa Hospital cancer centre, the treatment done in late September was a first in Canada. The Heart Institute is now one of the few centres in the world capable of performing it.
“This new technique offers patients a treatment option that does not require the body to be opened in any way,” Redpath said. “It’s a real game-changing innovation, almost a fairy tale.”
Although it is still experimental and being offered on a compassionate basis, Redpath believes the “sky is the limit” for the ways the procedure could change treatment of a common and often deadly heart arrhythmia called ventricular tachycardia, including enabling it to be performed on more patients in smaller centres using equipment used to treat cancer patients.
Sudden cardiac death kills around 50,000 Canadians every year. Most of those deaths are caused by ventricular arrhythmia, the condition that is the focus of the new non-invasive treatment.
Conventional treatment for ventricular arrhythmia involves surgery: usually through a catheter inserted in an artery or vein in the patient’s groin. Once inside, radio-frequency energy or other methods are used to destroy the damaged area of the patient’s heart muscle that is causing rapid and irregular heartbeats. That ablation, as it is known, is done to restore a regular heartbeat. More than 150 such surgeries are performed at the Heart Institute every year.
The new non-invasive procedure first performed in Ottawa last month could end the need for traditional heart surgery to treat the common and often deadly heart arrhythmia. Instead of time in an operating room, anesthesia, pain medicine and days of hospitalization and recovery, the patient who underwent the treatment last month put his shirt back on and walked home.
Current drug treatment for the condition are either ineffective or have side-effects, and the invasive procedures, including catheter ablation surgery or implanting a defibrillator, require prolonged surgery with potential complications and sometimes long recoveries.
The procedure that uses two novel therapies, took place in late September. First, the patient underwent electrocardiographic imaging, in which doctors mapped the electrical activity of his heart using advanced imaging technology.
During that procedure, the patient was fully awake and conscious, said Dr. Andrew Crean, co-director of the cardiac MRI service at the Heart Institute. He works with Redpath to identify damaged heart tissue causing arrhythmias.
Using that map, a radiation oncologist burned off damaged areas of the heart muscle, using technology normally used to treat cancer patients. No surgery was needed.
“We’re excited to use this treatment now on portions of the heart, with the hope that, with just one 30-minute treatment, our current patients will live longer and eventually contribute to research studies so we can learn more about who can benefit the most from this and by how much,” said Dr. Graham Cook, a radiation oncologist working on the treatment.
Redpath says he expects up to six patients to receive the treatment in Ottawa in coming months. They are all patients who are unable or unwilling to pursue conventional treatments.
So far, 30 patients have been treated, mostly through Washington University in St. Louis, where it was developed. Among those patients, there is a 94-per-cent success rate.
But before it can be widely used, the treatment will be studied to determine whether it is worthwhile.
Redpath said the procedure is significantly less costly than conventional treatment — maybe five times less than surgery.
If it were to become a routine treatment, he said, it could change how many patients were treated by allowing smaller hospitals to treat patients, even using it as a preventive procedure.
“The sky is the limit. There is really no limit to the number of patients that could be treated,” Redpath said. epayne@postmedia.com