Radiation Might Help Heart Regain Its Rhythm

辐射可能有助心脏恢复其节律

A flash of radiation drastically reduced arrhythmia in a small group of patients, for at least a year after treatment. Christopher Intagliata reports.

经过至少一年的治疗，辐射使一组病患心律不齐的情况明显减少。克里斯托弗·因塔利亚塔报道。

撰文\播音：克里斯托弗·因塔利亚塔（Christopher Intagliata）

翻译：邱燕宁

审校：潘磊

<> That beeping sound is the normal beating of a heart.

<<心电图（心脏跳动）的声音>>这种哔哔声是正常心脏跳动的声音。

<> But here's what the same heart sounds like, during a bout of ventricular tachycardia, or VT… the racing beats are caused by an electrical short circuit in the muscle. In a moment, defibrillator is going to zap the heart, to return it to a slow and steady pace.

<<快速的心电图（心脏跳动）的声音>>但是在室性心动过速（VT）时，心脏跳动的声音是这样的…这种加速的心脏跳动是由于肌肉生物电流短路的发生。用除颤器可以瞬间平复心脏，使其恢复到缓慢而稳定的节律。

The root cause of VT? "So the villain inside the heart is almost always a scar from a prior injury." Phillip Cuculich, a cardiac electrophysiologist at Washington University in Saint Louis. "Most commonly that's a prior heart attack or leftover scar from an infection that somebody might have, or an inflammatory disease someone might have."

VT的根本原因是什么?“潜伏在心脏里的恶因往往是以前受伤愈合的疤痕。”圣路易斯华盛顿大学的心电生理学家Phillip Cuculich说。“最常见的情况是，这个人可能先前心脏病发作或被感染而留下了疤痕，或者也可能因为一些炎症性疾病。”

That arrhythmia can be treated with drugs, or surgery, too: by inserting catheters up through the leg into the beating heart, and blasting the troublemaking scar tissue with heat. That kills the scar cells, and can coax the heart back to a normal rhythm.

这种心律不齐可以用药物治疗，也可以通过手术来治疗：将导管通过腿部伸入到跳动的心脏，然后利用热能来破坏制造麻烦的疤痕组织。这能杀死疤痕细胞，并能使心脏恢复正常的节律

But now Cuculich and his colleague Clifford Robinson are trying to achieve the heat treatment’s effect noninvasively, by blasting those tiny scarred patches of the heart with high-dose radiation… the kind used to destroy brain and lung tumors.

但是现在Cuculich和他的同事Clifford Robinson正试图实现非侵入性的热处理治疗，通过用大剂量的辐射来破坏心脏上的这些微小的伤痕…用来破坏大脑和肺部肿瘤组织的那种辐射。

"You might say that destroying heart doesn't sound appealing, and it doesn't sound like that's a good thing." But in a limited study of five patients who'd run out of other options, the treatment dramatically cut cases of arrhythmia. Before treatment, they collectively suffered more than 6500 bouts of arrhythmia in just three months. In the six weeks after treatment – the incidents plummeted to only about 700. And in the following year the group experienced only four arrhythmias, collectively…a 99.9 percent reduction. The method, which Cuculich and Robinson have a patent pending on, is described in The New England Journal of Medicine. [Phillip S. Cuculich, M.D. et al., Noninvasive Cardiac Radiation for Ablation of Ventricular Tachycardia]

“你可能会说，破坏心脏听起来不怎么吸引人，也不像是什么好事。”但在一项仅对5名不适用其他治疗方式的患者进行的研究中，该疗法明显减少了心律不齐的发生。在治疗之前，在仅仅三个月里，他们总共出现遭受了6500多次心律失常。而在治疗后的六周内，事故数量骤降至只有700起。在接下来的一年里，这组患者只发生4起心律失常…发生几率减少了99.9%。《新英格兰医学杂志》(The New England Journal of Medicine)中描述了Cuculich 和Robinson这一即将申请专利的疗法。

The treatment has advantages: it's just 15 minutes, compared to six to eight hours on an operating table. It seems at least as effective as the surgical treatment. And though a typical session of this radiation can cost tens of thousands of dollars, the doctors say that might still be cheaper than surgery and the resulting hospital stay.

这种疗法的优点是:只需要15分钟，而在手术台上需要6到8小时。它看起来至少和外科手术一样有效。虽然这种辐射的一次疗程可能要花费数万美元，但医生们认为这可能仍然比外科手术加住院费用来得便宜。

But there are uncertainties, like whether the radiation may contribute to cancer later in life, or damage nearby structures. And one patient had a fatal stroke three weeks after treatment…though it's unclear if the treatment had any connection. Robinson says that the technique might work like surgery, by damaging or killing scar cells, but the mechanism has not been proven.

但这种疗法也存在一些不确定性，比如辐射是否会导致之后癌症的发生，或损害附近的组织。有一个病人在使用该疗法三周后，遭遇一次致命的中风…虽然还不清楚是否和这种疗法有关联。Robinson说，这种技术可能会被当作手术的替代，通过破坏或杀死疤痕细胞来治疗，但具体机制尚未得到证实。

"This needs to be investigated in multiple levels, in the preclinical environment, looking at cells or animals. But this also could be investigated further in patients, by understanding what's happening using imaging, after the patient received their treatment. Or looking at how the signals of the heart change after treatment as well."

“这需要进行多层次的研究，在临床前期实验中，要观察用在细胞或动物上的效果。但也可能在病人身上进一步试验——病人接受治疗后可以通过成像技术了解其心脏变化，或者通过观察治疗后心脏信号变化的情况。

But if this radiation method proves safe and effective, it might be a simpler strategy…to help the heart regain its rhythm.

如果这种辐射方法被证明是安全有效的, 它会是一种更为简单的治疗方法…来帮助心脏恢复其节律。

—Christopher Intagliata