Linear accelerator–based stereotactic arrhythmia radioablation for paroxysmal atrial fibrillation in elderly patients: results from long-term follow-up - Report - MDSpire

Long-term Outcomes of Stereotactic Arrhythmia Radioablation Using Linear Accelerators for Paroxysmal Atrial Fibrillation in Older Adults

  • By

  • Antonio Di Monaco

  • Imma Romanazzi

  • Ilaria Bonaparte

  • Alessia Surgo

  • Alba Fiorentino

  • Massimo Grimaldi

  • July 20, 2026

Share

Long-term Outcomes of Stereotactic Arrhythmia Radioablation for AF

Overview

This study reports on the long-term outcomes of stereotactic arrhythmia radioablation (STAR) in elderly patients with paroxysmal atrial fibrillation (AF).

Background

Atrial fibrillation (AF) is a prevalent arrhythmia, particularly in older adults, and effective treatment options are crucial for this demographic. Stereotactic arrhythmia radioablation (STAR) represents a novel approach, yet its long-term outcomes in elderly patients remain underexplored.

Data Highlights

OutcomeDetails
Patients Enrolled20
Patients Undergoing STAR18
Quality of Life Improvement48 ± 15 at enrollment vs. 75 ± 15 at 12 months; P < 0.001
AF Recurrence at Median FUAll patients experienced at least one recurrence
Asymptomatic Pericardial Effusion8 patients (44%) at 12 months, 1 patient at long-term FU

Key Findings

  • STAR was performed with a total dose of 25 Gy delivered in a single fraction.
  • At 12-month follow-up, 44% of patients developed mild pericardial effusion, which resolved in most cases.
  • Quality of life significantly improved from enrollment to 12 months post-STAR.
  • All patients reported a reduction in symptomatic arrhythmic events and antiarrhythmic drug usage.
  • Three patients died during follow-up, with causes unrelated to STAR treatment.

Clinical Implications

Further studies are needed to establish the safety and efficacy of STAR compared to traditional catheter ablation.

Conclusion

Comprehensive safety and efficacy evaluations are essential for the clinical application of STAR.

Related Resources & Content

  1. Frontiers in Cardiovascular Medicine, 2026 -- Long-term follow-up of patients with pulmonary hypertension after catheter ablation of atrial fibrillation and atrial tachycardia
  2. Frontiers in Cardiovascular Medicine, 2026 -- Patient-reported and clinical outcomes after first-time atrial fibrillation ablation in older patients: a real-world retrospective single-center study
  3. Clinical Research in Cardiology, 2020 -- Post-Ablation Sinus Heart Rate and Long-Term Recurrence Risks in Patients with Atrial Fibrillation
  4. Frontiers in Cardiovascular Medicine, 2026 -- Long-term outcome of patients with atrial fibrillation and heart failure with preserved ejection fraction after combined radiofrequency catheter ablation and left atrial appendage closure
  5. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) | European Heart Journal | Oxford Academic
  6. Target delineation workflow and outcomes of stereotactic cardiac radioablation - ScienceDirect
  7. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) | European Heart Journal | Oxford Academic
  8. Target delineation workflow and outcomes of stereotactic cardiac radioablation - ScienceDirect

Original Source(s)

Linear accelerator–based stereotactic arrhythmia radioablation for paroxysmal atrial fibrillation in elderly patients: results from long-term follow-up

  • by Antonio Di Monaco, Imma Romanazzi, Ilaria Bonaparte, Alessia Surgo, Alba Fiorentino, Massimo Grimaldi

  • July 20, 2026

Related Content

Mandatory Training Modules Deserve a Harder Look

A JAMA Viewpoint argues that 4 million physician-hours spent on compliance modules each year warrants institutional reassessment.

FDA Broadens Pitolisant Label

The US Food and Drug Administration approves pitolisant (WAKIX) tablets for the treatment of cataplexy in pediatric patients aged 6 years and older with narcolepsy.

Sudden Death Trajectories in HFpEF, HFmrEF

Clinical changes before death overlap across outcomes