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

To report the long-term follow-up of elderly patients with paroxysmal atrial fibrillation treated with stereotactic arrhythmia radioablation (STAR).

Patient Enrollment: Patients aged 70 years or older with symptomatic AF and ineffective or unusable antiarrhythmic therapy were enrolled.
Treatment Methodology: STAR was performed with a total dose of 25 Gy delivered with high precision to the target and organs at risk.
Follow-Up: Longitudinal follow-up was maintained through clinical evaluations, ECG, echocardiography, and Holter monitoring.

18 out of 20 enrolled patients underwent STAR.
44% of patients developed mild pericardial effusion at 12-month follow-up, which resolved in most cases by long-term follow-up.
Quality of life improved significantly from 48 ± 15 at enrollment to 75 ± 15 at 12 months (P < 0.001).
All patients experienced at least one AF recurrence, but reported a reduction in symptomatic arrhythmic events and antiarrhythmic drug usage.

The data demonstrate the feasibility of STAR in elderly patients with paroxysmal AF.

The treatment remains experimental and requires more comprehensive safety data.
Efficacy needs further evaluation in a comparative study versus catheter ablation.

Further studies are necessary to establish the safety and efficacy of STAR in elderly patients with paroxysmal AF.