For 40 years, 63-year-old Nazia Matar suffered from a heart condition, with his condition worsening day by day. “My condition was so severe that my pacemaker shocked me twice a day, and I had lost all hope of living – until doctors at Rambam Health Care Campus offered me the chance to participate in an innovative study involving heart radiotherapy. I agreed because I already felt half-dead. I love life and want to keep living, and that’s why I agreed to try something new after every existing treatment had failed.
“At first, I didn’t really believe the new treatment would help, but the heart radiotherapy, which I underwent only once and without anesthesia, gave me my life back. Last week, I went fishing with my sons. I sat by the sea for the first time in many years, and my heart was filled with joy,” he shared emotionally.
This groundbreaking research at Rambam uses heart radiotherapy to stop severe, life-threatening arrhythmias in patients for whom no other treatments have worked. The radiotherapy is performed in a way that is similar to that which is used for cancer patients.
“It’s a single, concentrated radiation session at a high dose, precisely targeting the area causing the arrhythmia. The treatment takes only a few minutes, with minimal damage to nearby healthy tissues, and the results are very promising,” said Dr. Tomer Charas, deputy director of the Oncology Department, radiation oncology specialist, and head of innovation and regional partnerships at Rambam’s Oncology Department.
“I told the doctor, I’m done, I’m going to die today”
Matar, a resident of Haifa who is married to Amal, father of three sons, and grandfather to two grandchildren, shared what it was like to live with the disease. “I worked in an office job at the Haifa Port for many years, but the heart disease I had suffered from since I was 23 gradually worsened. It actually started in childhood, with arthritis. I remember three particularly severe attacks at ages 6, 13 and then 23. Right after the third episode, I was diagnosed with valve damage in my heart. They replaced the valve, and for 25 years I lived normally. I got married, worked, my sons were born and everything was fine. But slowly, my condition began to deteriorate. I had an irregular heartbeat, then heart failure, obesity, drug side effects – until my heart needed help, and they implanted a pacemaker.”
He explained that people tend to believe that a pacemaker solves all problems.
“People think that having a pacemaker-defibrillator means you might feel a small prick or mild discomfort when it activates, but nothing could be further from the truth. Life with a pacemaker was not easy. It’s endless fear, anxiety and trauma from the electrical shocks (defibrillators) that regulated my heart. You never know when they’ll hit, and it’s constant tension. I would sit and listen to my heartbeat, not knowing when the next shock would come. Slowly, I went from being an optimistic person to someone afraid to leave the house alone, afraid to walk down the street. Not to mention shortness of breath, fatigue, and exhaustion – even when I wasn’t doing anything.
“At night, I would sleep propped up on three pillows, almost sitting, or I’d jump out of bed in panic because I couldn’t breathe. Then came the shocks, the screams, the whole house awake, and I could see the fear in my family’s eyes. The worst night was last April – I got shocked seven times within a few minutes. The pain was unbearable. They called an ambulance, and I was hospitalized in intensive care for 12 days as they tried to stabilize me with various medications, but the side effects were severe, and nothing helped. Shortly after being discharged, I returned to Rambam for follow-up. I sat there and told the doctor, ‘That’s it. I’m done. I’m going to die here today.’ She did an EKG and other tests, and all the doctors immediately gathered around me, trying to encourage me and figure out what else could be done– maybe something creative after everything else had failed.”
Now, after undergoing the treatment, he is more optimistic than ever. “My life has changed. The pacemaker hasn’t activated even once. I no longer sit and listen to my heart. You could say I’m very optimistic. Not 100%, but pretty close. It’s important to me to give hope to others – that even when everything seems lost, there’s always hope from an unexpected place. And if there’s hope, grab it with both hands,” he said.
'Treatment brings hope'
“This innovative procedure, made possible through collaborative research by Rambam researchers, physicist Dr. Igor Borzov, and Dr. Oliver Blank from the University of Kiel in Germany, required close cooperation between several hospital departments, including cardiology, radiation unit, radiology, day hospitalization and intensive care units,” explained Dr. Charas.
“After identifying that the source of the arrhythmia was located on the outer part of the heart, precise planning was required using advanced mapping and imaging technology. A single, concentrated, high-dose radiation session was performed, targeting the exact spot of the arrhythmia. The treatment lasted only a few minutes, with minimal damage to adjacent healthy tissues, and the results are very promising,” he said.
Prof. Mahmoud Suleiman, senior cardiologist specializing in Clinical Electrophysiology at Rambam’s cardiology department, added that all other treatment options for Nazia had been exhausted, including valve replacement surgery.
“We considered performing ablation (burning) of the specific area in the left ventricle of the heart where the arrhythmia was identified, but during the catheterization procedure, we discovered that the arrhythmia was actually outside the heart. Therefore, ablation was impossible, as the patient had already undergone valve replacement surgery. All medication options had also been exhausted, leaving the innovative treatment as the only solution,” he explained.
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He explained the heart’s role in pumping blood throughout the body, with its contraction and expansion controlled by a sophisticated electrical system. The natural pacemaker dictates the rhythm for the heart’s different parts. “In various heart diseases, this precise electrical timing is disrupted, leading to desynchronized heart activity. The most extreme case of electrical arrhythmia is ventricular fibrillation, where the synchronization between the heart’s chambers is lost due to disruption in the electrical timing. As a result, the heart cannot effectively pump blood out, and without quick treatment, the condition can lead to death. In Israel, hundreds of thousands of people suffer from heart rhythm disorders,” Suleiman said.
“We were amazed by the results,” said Professor Salem Billan, director of Rambam’s Radiotherapy Institute, who was part of the treatment team. “This outcome wasn’t just seen in the first patient in Israel but also in another patient. For the first patient, Nazia, the pacemaker went from activating several times a day to not activating even once in the past year. The second patient, who underwent the procedure eight months ago, also hasn’t had the pacemaker activate even once.”
Kharas concluded: “This is a breakthrough offering hope for patients suffering from heart arrhythmias, who haven’t been able to achieve balance with existing treatments and who are not suitable candidates for ablation therapy.”