Paroxysmal Atrial Fibrillation in Elderly: Worldwide Preliminary Data of LINAC-Based Stereotactic Arrhythmia Radioablation Prospective Phase II Trial

Antonio Di Monaco, Fabiana Gregucci, Ilaria Bonaparte, Federica Troisi, Alessia Surgo, Domenico Di Molfetta, Nicola Vitulano, Federico Quadrini, Roberta Carbonara, Gaetano Martinelli, Pietro Guida, Maria Paola Ciliberti, Alba Fiorentino, Massimo Grimaldi, Antonio Di Monaco, Fabiana Gregucci, Ilaria Bonaparte, Federica Troisi, Alessia Surgo, Domenico Di Molfetta, Nicola Vitulano, Federico Quadrini, Roberta Carbonara, Gaetano Martinelli, Pietro Guida, Maria Paola Ciliberti, Alba Fiorentino, Massimo Grimaldi

Abstract

Treatment approach for elderly patients with atrial fibrillation (AF) is difficult. The present prospective phase-II trial evaluated LINAC-based stereotactic arrhythmia radioablation safety in this population. The reported data of the first 5 patients worldwide, showed no side effects, absence of AF episodes and without antiarrhythmic drugs.

Trial registration: ClinicalTrials.gov, identifier: NCT04575662.

Keywords: arrhythmia; atrial fibrillation (AF); elderly patients; radioablation; stereotactic body radiotherapy.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Di Monaco, Gregucci, Bonaparte, Troisi, Surgo, Di Molfetta, Vitulano, Quadrini, Carbonara, Martinelli, Guida, Ciliberti, Fiorentino and Grimaldi.

Figures

Figure 1
Figure 1
The workflow of LINAC-based STAR. (A) Simulation procedures. (B) Organs at risks and target volume identification. (C) Treatment planning.

References

    1. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. . 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. (2021) 42:373–498. 10.1093/eurheartj/ehaa612
    1. Kennedy R, Oral H. Catheter ablation of atrial fibrillation in the elderly: does the benefit outweigh the risk? Expert Rev Cardiovasc Ther. (2013) 11:697–704. 10.1586/erc.13.2
    1. Fiorentino A, Gregucci F, Bonaparte I, Vitulano N, Surgo A, Mazzola R, et al. . Stereotactic Ablative radiation therapy (SABR) for cardiac arrhythmia: a new therapeutic option? Radiol Med. (2021) 126:155–62. 10.1007/s11547-020-01218-7
    1. Bonaparte I, Gregucci F, Surgo A, Di Monaco A, Vitulano N, Ludovico E, et al. . Linac-based STereotactic Arrhythmia Radioablation (STAR) for ventricular tachycardia: a treatment planning study. Jpn J Radiol. (2021) 39:1223–8 10.1007/s11604-021-01159-9
    1. Fiorentino A, Di Monaco A, Surgo A, Vitulano N, Gregucci F, Ludovico E, et al. . Linac-based STereotactic Arrhythmia Radioablation (STAR) of ventricular tachycardia: case report and literature review. Clin Case Rep. (2020) 9:362–6. 10.1002/ccr3.3530
    1. Lydiard S, Blanck O, Hugo G, O'Brien R, Keall P. A review of Cardiac Radioablation (CR) for arrhythmias: procedures, technology, and future opportunities. Int J Radiat Oncol Biol Phys. (2021) 109:783–800. 10.1016/j.ijrobp.2020.10.036
    1. Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T, et al. . Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. (2018) 19:591–600. 10.1093/ehjci/jey042
    1. Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, et al. . Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys. (2010) 37:4078–101. 10.1118/1.3438081
    1. Monroy E, Azpiri J, De La Peña C, Cardona C, Hinojosa M, Zamarripa R, et al. . Late gadolinium enhancement cardiac magnetic resonance imaging post-robotic Radiosurgical Pulmonary Vein Isolation (RRPVI): first case in the world. Cureus. (2016) 8:e738. 10.7759/cureus.738
    1. Qian PC, Azpiri JR, Assad J, Gonzales Aceves EN, Cardona Ibarra CE, de la Pena C, et al. . Noninvasive stereotactic radioablation for the treatment of atrial fibrillation: First-in-man experience. J Arrhyth. (2020) 36:67–74. 10.1002/joa3.12283
    1. Di Monaco A, Quadrini F, Troisi F, Vitulano N, Cecere G, Guida P, et al. . Bilateral left lateral ridge ablation increases the long-term success of patients ablated for atrial fibrillation. J Cardiovasc Med (Hagerstown). (2019) 20:186–91 10.2459/JCM.0000000000000779
    1. Jumeau R, Ozsahin M, Schwitter J, Elicin O, Reichlin T, Roten L, et al. . Stereotactic radiotherapy for the management of refractory ventricular tachycardia: promise and future directions. Front Cardiovasc Med. (2020) 7:108. 10.3389/fcvm.2020.00108
    1. Laish-Farkash A, Perelshtein Brezinov O, Valdman A, Tam D, Rahkovich M, Kogan Y, et al. . Evaluation of left atrial remodeling by 2D-speckle-tracking echocardiography versus by high-density voltage mapping in patients with atrial fibrillation. J Cardiovasc Electrophysiol. (2021) 32:305–15. 10.1111/jce.14837

Source: PubMed

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