Secondary endpoint
arrhythmia, atrial fibrillation, phrenic nerve damage, fibrosis, atrial flutter, atrial tachycardias, atrial ectopies, stenosis, arrhythmias
RECURRENCES, ARRHYTHMIA, ATRIAL FIBRILLATION, TYPICAL ATRIAL FLUTTER, FIBROSIS, ATRIAL FLUTTER, ATRIAL TACHYCARDIAS, ARRHYTHMIAS, STENOSIS
Frequent atrial ectopies (>1000/24 h) and atrial tachycardias episodes were documented in all patients during the first 2 months after STAR. Most patients had a significant reduction in AF episodes during FU (Incidence rate of atrial fibrillation episodes by time since STAR treatment and risk of atrial fibrillation for time at risk after thereafterPatients 1 and 3 had a symptomatic atypical atrial flutter at 6 months post-STAR, while Patient 13 had an episode of atypical atrial flutter after 12 months. No other significant arrhythmias were documented.All the patients with arrhythmia recurrences resumed AAT with beta-blockers; one patient started flecainide 6 months from STAR, and two patients started amiodarone after 3 and 12 months from STAR.All patients with recurrent arrhythmias were offered to undergo an electrophysiological study (ES), but most of them refused due to a significant improvement in symptoms. Five patients performed ES (Patients 1, 3, and 13 presenting an atypical atrial flutter and Patients 5 and 9 with paroxysmal AF). In these patients, the atrial mapping using CARTO System and Pentaray or Octaray mapping catheters (Biosense Webster, CA, USA) were performed and no PV stenosis or phrenic nerve damage was documented.Electrophysiological study performed after 6 months from STAR:Patient 1: PVI was documented; high-rate atrial stimulation induced the clinical atrial flutter whose critical isthmus was ablated in a low-voltage area in the anterior wall (this area was far from targeted areas of STAR) (Patient 3: ES documented PVI, absence of low-voltage areas in both atria. Programmed and high-rate atrial stimulation was not able to induce any arrhythmia (Electroanatomic mapping of the left atrium using CARTO System and Pentaray catheter. (Electroanatomic mapping of the left atrium using CARTO System and Pentaray catheter. (Electrophysiological study performed after 12 months from STAR:Patient 9 documented PVI with lesions performed distally in the superior veins (Patient 5 had PVI with high grade of left atrial fibrosis (Patient 13 had PVI, and left atrial posterior wall did not show any electrical activity (Electroanatomic mapping of the left and right atrium using CARTO System and Octaray catheter. (Electroanatomic mapping of the left atrium using CARTO System and Octaray catheter. (Electroanatomic mapping of the left atrium using CARTO System and Pentaray catheter. (A significant improvement of quality of life was documented after STAR (48 ± 15 at enrolment vs. 75 ± 15 at 12 months FU; 