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Updated: Dec 3, 2025
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Published on: May 26, 2015
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Advantages and challenges for noninvasive atrial fibrillation ablation
Masaaki Shoji1, Koji Inaba2, Jun Itami2
1Department of Cardiovascular Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan. shoji.sgh@me.com.
Summary
Stereotactic arrhythmia radioablation (STAR) offers a novel, non-invasive approach for atrial fibrillation (AF) treatment. Early results suggest STAR is safe and can achieve electrical isolation, warranting further investigation for efficacy.
Area of Science:
- Cardiology
- Radiation Oncology
- Medical Physics
Background:
- Catheter ablation is effective for atrial fibrillation (AF) but carries risks.
- Improved therapeutic efficacy for AF is desirable.
- Stereotactic radiotherapy offers precise, non-invasive treatment for malignancies.
Purpose of the Study:
- To evaluate stereotactic arrhythmia radioablation (STAR) as a therapeutic option for AF.
- To assess the safety and feasibility of non-invasive radioablation for the left atrium.
- To explore STAR's potential as an alternative to catheter ablation for AF.
Main Methods:
- Three cancer patients with drug-refractory AF were enrolled.
- 3-D CT imaging and planning software were used to define a "box" lesion set in the left atrium.
- Patients received stereotactic arrhythmia radioablation (STAR) in a dedicated suite.
Main Results:
- STAR successfully delivered the planned radiation dose to the target in all patients.
- No complications were observed during a 24-month follow-up period.
- Autopsy in one patient showed evidence of fibrogenesis in the targeted atrial tissue, and electrograms indicated successful electrical isolation in another.
Conclusions:
- This study reports the first non-invasive radioablation of the left atrium demonstrating successful electrical isolation.
- STAR appears to be a safe method for delivering ablative energy to the left atrium.
- Further research is needed to confirm the effectiveness of STAR for treating atrial fibrillation.
