CyberKnife used for new heart research

CyberKnife, the robotic surgery system most often used to treat cancer and inoperable tumors, could one day be used to correct abnormal heart rhythms – replacing the current invasive surgery with painless laser zaps.
 
Community Regional Medical Center doctors have just completed the initial phase of groundbreaking, original research and development of the CyberHeart project.
It could have far-reaching impact, changing the way cardiac disease is treated around the world, said Dr. John Ambrose, chief of cardiology for UCSF Fresno Medical Education Program.

 

 

 
Dr. John Ambrose

“The idea is phenomenol,” said Dr. Ambrose who was involved in the research along with CyberKnife director Dr. Douglas Wong and Dr. Chandrasekar Venugopal, of diagnostic radiology. “This is a real common problem and the way this gets fixed now is through a six-hour procedure.”

Nationwide, atrial fibrillation affects 1 in 25 adults 60 or older and is the most common cause of irregular heartbeat, accounting for a third of all hospitalizations for arrhythmias. Atrial fibrillation is a heart condition in which the atria or chambers of the heart that receive blood contract rapidly and out of sync with the vetricles or chambers of the heart that pump blood. Those with atrial fibrillation have seven times the risk for major stroke and double the risk of death from heart disease.

To fix the problem currently, cardiac surgeons insert catheters through various veins in the groin and neck to introduce radiofrequency currents that scar parts of the heart muscle. Such destruction of bits of the heart tissue act to regulate the heart beat. But the procedure has a success rate of 52% and 6% of patients experience major complications – mostly from the insertion of the catheters. CyberKnife might one day accomplish the same thing without any incisions, delivering tiny precise laser bursts to heart tissue while the heart is beating.

“CyberKnife is an enabling technology,’ said Dr. Wong, the principal radiation oncologist at Community Regional and California Cancer Center. “It’s brought some very smart minds to think about new paradigms to approaching old problems.”

All 20 of the CyberHeart research volunteers were Community Medical Centers employees, who agreed to undergo blood tests, a cardiac CT scan and CyberKnife X-ray imaging to study how the heart moves. The baseline information collected by Community will be used to design the first international human trials of CyberKnife treatment for atrial fibrillation.

Dr. Ambrose said he was surprised that so many employees readily and enthusiastically signed up to be involved – especially since it could take as many as five years for such research to result in any change in cardiac treatments.

But it was the thought that she might need such treatment and Patti Groh’s own experience with heart surgery that prompted her to volunteer for the research. The social worker for Community’s outpatient dialysis program explained, “I had a three-vessel bypass at age 46, so anything having to do with research with the heart was of interest to me. If I have that problem in the future I’d sure like to have CyberKnife instead of surgery.”

Alison Wells, a client services manager in information systems, said she is of an age where heart disease can be a worry. “I'm getting old and I basically had my heart assessed by our expert doctors for free.”

Similar worries motivated Lorraine Vargas, a registered nurse and clinical analyst for information services. And, she said, because of her family’s history of heart disease, she wanted to make a difference in cardiac care. As a nurse she was also curious to experience what patients might go through with CyberKnife.

Curiosity also drew Jack Buchanan, an information systems manager, who wanted to see CyberKnife technology up close. “I also thought this was just really thinking outside the box for non-invasive heart treatment,” Buchanan said. “Any time you can forego anesthesia and cutting into someone you just bypass a lot of risks. With this procedure, you just get up and walk away afterwards.”

Employees who were involved said they were excited to be part of what they see as a prestigious project for Community that could eventually revolutionize heart treatment.

Sharon Wimberley, a clinical information systems trainer, said, "This may sound old fashioned, but I believe it's important, to ‘give back’ – back to my community, back to my employer of more than 17 years, and back to the world I am blessed to live in.”


This story was reported by Erin Kennedy. She can be reached at ekennedy@communitymedical.org.