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RT Offers Hope for High-Risk Arrhythmia Patients

By MedImaging International staff writers
Posted on 09 Oct 2019

A single, high dose of radiation therapy (RT) can dramatically reduce episodes of ventricular tachycardia (VT) for more than two years, according to a new study.

Developed at the Washington University (WUSTL; St. Louis, MO, USA) School of Medicine, the noninvasive, outpatient procedure for treating VT is called EP-guided noninvasive cardiac radioablation (ENCORE). The novel therapy fuses electrocardiogram (ECG) and imaging data to pinpoint the scar tissue in the patient's heart responsible for the arrhythmias, and then targets it with a single dose of stereotactic body radiation therapy (SBRT). ENCORE requires no general anesthesia, and allows patients to go home immediately after treatment.

In a phase I/II prospective trial, 19 patients who had life-threatening VT were treated with a single fraction (25 Gy) of SBRT. ENCORE led to a 94% reduction in VT episodes in the first six months after SBRT, with longer-term follow-up data showing that the effect persisted in 78% of patients for more than two years; overall survival was 52% after the second year. Of the nine patients who died, six suffered from cardiac deaths (heart failure and VT recurrence) and three from non-cardiac deaths (accident, amiodarone toxicity, and pancreatic cancer). The study was presented at the 61st annual meeting of the American Society for Radiation Oncology (ASTRO), held during September 2019 in Chicago (IL, USA).

“Patients come to us as a last line of defense. They have few or no other options. Often, the primary reason we are treating them is because they were too sick to have more catheter ablation,” said lead author and study presenter Clifford Robinson, MD, an associate professor of radiation oncology and cardiology at WUSTL. “Given the relative novelty of this treatment approach, we are following our patients closely, conducting trials to gather more data and being careful not to make assumptions at this point.”

“An additional benefit to treatment was a reduction in the medications patients were taking, which resulted in fewer medication-related side effects and a higher quality of life,” concluded Dr. Robinson. “These patients were on heavy doses of medications, with side effects such as liver damage, lung damage, nausea, and thyroid problems. After they were treated, we could dramatically reduce their medications. We saw reduced VT, reduced medication and improved quality of life, at least in the intermediate term.”

In VT, the electrical signals in the heart’s lower chambers misfire, crippling the relaxation and refilling process and producing rapid arrhythmias. First line treatment for VT includes pharmaceuticals and an implantable cardioverter defibrillator (ICD). Patients with recurrent VT often also undergo catheter ablation, which requires general anesthesia, takes up to nine hours to perform, holds a 5% mortality risk, and has a 50% chance that it won't stop VT arrhythmias from recurring. If catheter ablation does not control the VT, patients are left with few options beyond a heart transplant.

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62 (!!!!! 5523.9200592041): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

63 (113.96408081055): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

64 (582.93342590332): SELECT fid FROM jos_deeppockets WHERE id=294779619 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294779619 AND published='1' LIMIT 1

65 (62.942504882812): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

66 (72.956085205078): select jos_twitters.link from jos_twitters where cat=10

67 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

68 (41.007995605469): select jos_google_plus.link from jos_google_plus where cat=10

69 (46.014785766602): select jos_linkedin.link from jos_linkedin where cat=10

70 (172.13821411133): SELECT fid FROM jos_deeppockets WHERE id=294779619 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294779619 AND published='1' LIMIT 1

71 (172.13821411133): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

72 (838.04130554199): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (424.14665222168): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (434.16023254395): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

75 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (54.836273193359): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (!!!!! 1502.0370483398): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

92 (643.96858215332): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (174.99923706055): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (135.89859008789): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (403.88107299805): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (50.783157348633): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (108.95729064941): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (!!!!! 5249.0234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

107 (104.18891906738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

108 (250.10108947754): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779619 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (550.98533630371): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779619 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (!!!!! 2334.8331451416): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

111 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

112 (77.962875366211): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294779619 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (527.85873413086): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294779619 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (621.79565429688): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

115 (368.11828613281): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

117 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

118 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

119 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

120 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

122 (327.11029052734): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 44424.057006836): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

125 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

126 (591.99333190918): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779619 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779619 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 1983812.8089905): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

128 (!!!!! 2206673.8605499): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (!!!!! 7864.9520874023): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

130 (!!!!! 7968.9025878906): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

131 (!!!!! 7699.9664306641): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

132 (!!!!! 7965.087890625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

133 (!!!!! 7869.0052032471): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

134 (!!!!! 7974.1477966309): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

135 (339.03121948242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (319.9577331543): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (113.96408081055): SELECT name FROM jos_deeppockets WHERE id=213

138 (118.97087097168): SELECT name FROM jos_deeppockets WHERE id=213

139 (455.14106750488): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (348.80638122559): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (930.0708770752): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

142 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

143 (!!!!! 13564.109802246): TRUNCATE TABLE jos_trademed_module

144 (887.15553283691): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779619 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 6365.0608062744): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779619 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2987.1463775635): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

149 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

150 (!!!!! 2825.9754180908): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

152 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

153 (!!!!! 9685.0395202637): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779619 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779619 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (128.03077697754): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

155 (33.140182495117): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

156 (32.901763916016): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (136.13700866699): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

158 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779619 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779619 AND published='1' LIMIT 1

159 (50.067901611328): select jos_twitters.link from jos_twitters where cat=10

160 (26.941299438477): select jos_facebook.link from jos_facebook where cat=10

161 (26.941299438477): select jos_google_plus.link from jos_google_plus where cat=10

162 (27.179718017578): select jos_linkedin.link from jos_linkedin where cat=10

163 (224.11346435547): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1223.087310791): insert into jos_banners_delta values (14615,'2025-04-30 04:11:47','3.12.148.147','view'),(14202,'2025-04-30 04:11:47','3.12.148.147','view'),(14203,'2025-04-30 04:11:47','3.12.148.147','view')

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