Radiation oncologists rarely, if ever, treat the heart. In fact, they try to avoid exposing the heart to x-ray beams at all costs. However, a new treatment recently performed at Orlando Health has successfully given time and quality of life back to heart patients. Precise radiation therapy gives patients who have few remaining treatment options.
Out of options
Dewey Caldwell was the first patient to receive this experimental therapy at Orlando Health. Caldwell’s condition had deteriorated to a point that left him bedridden. He suffered over two dozen heart attacks and, as his heart sustained more damage, there were fewer options to treat him. Each heart attack left him weaker, to where medications were no longer effective.
Caldwell and his wife were planning to discontinue treatment when Dr. Filart approached them with a new option. The treatment would use cardiac mapping and extremely precise radiation to treat the exact part of the heart that disrupted the electrical circuit with pinpoint accuracy. Down to the millimeter.
“We can use multiple different beam angles from all sorts of different directions to focus on any particular point in the body. While avoiding sending x-rays through other parts that we don’t want to treat,” said Justin Rineer, MD. He’s a radiation oncologist at Orlando Health Cancer Institute.
Luis Garcia, MD, performs a heart ablation at Orlando Health Heart and Vascular Institute. The procedure is effective in correcting arrhythmias by targeting tissue that disrupts the heart’s normal rhythm. However, not all patients are healthy enough to undergo the procedure. So an experimental treatment uses radiation to achieve the same effect non-invasively. 
Dewey Caldwell spends time with his wife after undergoing an experimental treatment. 
Dewey Caldwell wears a vest designed to precisely map the heart. This is in preparation for an experimental therapy . 
Roland Filart, MD, and heart patient Dewey Caldwell at the Orlando Health Heart and Vascular Institute.
Gaining more time
The concept is like a heart ablation, but completely non-invasive. This makes it a viable option for patients who are too weak or sick to undergo surgery. In the weeks that followed therapy, Caldwell’s energy increased, and he used the defibrillator far less often. This allowed him to spend quality time with his loved ones.
“I got on a plane and went to my 60th high school reunion. Which is something I never thought I’d be able to do,” Caldwell said. “My doctors never gave up on me and found a treatment that never even existed, but has made all the difference for me.”
Many doctors still consider the treatment experimental. It is usually only approved for compassionate use, not as a first line treatment. It is an option only made possible through extensive planning and collaboration to translate cardiac heart mapping technology to work with radiation software and equipment.
