{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:36:10Z","timestamp":1790242570694,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Particle therapy is a noninvasive, catheter-free modality for cardiac ablation. We previously demonstrated the efficacy for creating ablation lesions in the porcine heart. Despite several earlier studies, the exact mechanism of early biophysical effects of proton and photon beam delivery on the myocardium remain incompletely resolved.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Ten normal and 9 infarcted in situ porcine hearts received proton beam irradiation (40 Gy) delivered to the left ventricular myocardium with follow-up for 8 weeks. High-resolution electroanatomical mapping of the left ventricular was performed at baseline and follow-up. Bipolar voltage amplitude, conduction velocity, and connexin-43 were determined within the irradiated and nonirradiated areas.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The irradiated area in normal hearts showed a significant reduction of bipolar voltage amplitude (10.1\u00b14.9 mV versus 5.7\u00b13.2,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) and conduction velocity (85\u00b126 versus 55\u00b113 cm\/s,\n              <jats:italic>P<\/jats:italic>\n              =0.03) beginning at 4 weeks after irradiation. In infarcted myocardium after irradiation, bipolar voltage amplitude of the infarct scar (2.0\u00b12.9 versus 0.8\u00b10.7 mV,\n              <jats:italic>P<\/jats:italic>\n              =0.008) was significantly reduced as well as the conduction velocity in the infarcted heart (43.7\u00b115.7 versus 26.3\u00b111.4 cm\/s,\n              <jats:italic>P<\/jats:italic>\n              =0.02). There were no significant changes in bipolar voltage amplitude and conduction velocity in nonirradiated myocardium. Myocytolysis, capillary hyperplasia, and dilation were seen in the irradiated myocardium 8 weeks after irradiation. Active caspase-3 and reduction of connexin-43 expression began in irradiated myocardium 1 week after irradiation and decreased over 8 weeks.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Irradiation of the myocardium with proton beams reduce connexin-43 expression, conduction velocity, and bipolar conducted electrogram amplitude in a large porcine model. The changes in biomarkers preceded electrophysiological changes after proton beam therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.122.011179","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T09:00:21Z","timestamp":1684141221000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Early Impact of Proton Beam Therapy on Electrophysiological Characteristics in a Porcine Model"],"prefix":"10.1161","volume":"16","author":[{"given":"Kimitake","family":"Imamura","sequence":"first","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Deisher","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0374-4983","authenticated-orcid":true,"given":"Jannis","family":"Dickow","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7581-3570","authenticated-orcid":true,"given":"Maryam E.","family":"Rettmann","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Z.","family":"Yasin","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8673-9943","authenticated-orcid":true,"given":"Mark D.","family":"Pepin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1606-3423","authenticated-orcid":true,"given":"Stephan","family":"Hohmann","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5365-6239","authenticated-orcid":true,"given":"Hiroki","family":"Konishi","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9810-928X","authenticated-orcid":true,"given":"Atsushi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7588-948X","authenticated-orcid":true,"given":"Laura K.","family":"Newman","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., D.L.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (X.S.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6177-2077","authenticated-orcid":true,"given":"Jon J.","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth W.","family":"Merrell","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3470-6872","authenticated-orcid":true,"given":"Robert L.","family":"Foote","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (A.J.D., M.D.P., J.J.K., K.W.M., M.G.H., R.L.F.), Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-869X","authenticated-orcid":true,"given":"Douglas L.","family":"Packer","sequence":"additional","affiliation":[{"name":"Translational Interventional Electrophysiology Laboratory, Mayo Clinic\/St. Mary\u2019s Campus (K.I., J.D., M.E.R., O.Z.Y., S.H., H.K., A.S., L.K.N., 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