Linear accelerator–based stereotactic arrhythmia radioablation for paroxysmal atrial fibrillation in elderly: a prospective phase II trial

Author:

Di Monaco Antonio12ORCID,Gregucci Fabiana3,Bonaparte Ilaria3,Romanazzi Imma1,Troisi Federica1ORCID,Surgo Alessia3ORCID,Vitulano Nicola1,Quadrini Federico1ORCID,Valenti Noemi1ORCID,Carbonara Roberta3ORCID,Di Guglielmo Fiorella Cristina3,Ludovico Elena4,Calbi Roberto4ORCID,Guida Pietro1,Ciliberti Maria Paola3ORCID,Fiorentino Alba35ORCID,Grimaldi Massimo1ORCID

Affiliation:

1. Department of Cardiology, General Regional Hospital ‘F. Miulli’ , Acquaviva delle Fonti 70021 , Bari, Italy

2. Department of Clinical and Experimental Medicine, University of Foggia , Viale Luigi Pinto 71122 Foggia , Italy

3. Department of Radiation Oncology, General Regional Hospital ‘F. Miulli’ , Acquaviva delle Fonti, Bari , Italy

4. Department of Radiology, General Regional Hospital ‘F. Miulli’ , Acquaviva delle Fonti, Bari , Italy

5. Department of Medicine and Surgery, LUM University, Casamassima , Bari , Italy

Abstract

Abstract Aims Stereotactic arrhythmia radioablation (STAR) is a novel therapeutic approach for cardiac arrhythmias. The aim of this trial is to investigate the feasibility of STAR for the treatment of paroxysmal atrial fibrillation (AF) in elderly patients. Methods and results Inclusion criteria were age >70 years, symptomatic AF, antiarrhythmic drugs failure, or intolerance. All patients underwent to 4D cardiac computed tomography simulation. The clinical target volume was identified in the area around pulmonary veins (PV). Stereotactic arrhythmia radioablation was performed with a total dose of 25 Gy (single fraction) delivered in 3 min. Twenty patients were enrolled and 18 underwent STAR. One patient withdrew informed consent before treatment and one patient was excluded due to unfavourable oesophagus position. With a median follow-up (FU) of 16 months (range 12–23), no acute toxicity more than Grade 3 was reported. Five patients had a Grade 1 oesophagitis 24 h after STAR; eight patients had an asymptomatic Grade 1 pericardial effusion, and one patient had a torsade de pointes treated effectively by electrical cardioversion and subsequent cardiac implantable cardioverter-defibrillator implantation. Most patients had a significant reduction in AF episodes. Five patients, due to arrhythmias recurrences after STAR, performed electrophysiological study documenting successful PV isolation. Finally, a significant improvement of quality of life was documented (48 ± 15 at enrolment vs. 75 ± 15 at 12 months FU; P < 0.001). Conclusion The present phase II trial demonstrated the feasibility of STAR in paroxysmal AF elderly patients and its potential role in increasing the quality of life. Surely, more robust data are needed about safety and efficacy. Trial registration ClinicalTrials.gov: NCT04575662

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3