Background and Aims: Stereotactic arrhythmia radioablation (STAR) is increasingly used for refractory ventricular tachycardia (VT), yet prospective multicentre outcome data remain limited. Here, the planned interim analysis of the prospective Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary (STOPSTORM) registry is reported. Methods: STOPSTORM is a European prospective, international, multicentre registry of patients treated with STAR. The primary efficacy endpoint was the change in sustained VT episode burden comparing the 6 months before versus the 6 months after STAR. The primary safety endpoint was the occurrence of serious adverse events (SAEs) adjudicated as possibly or probably treatment-related. Overall survival was assessed using time-to-event methods. Results: Across 28 centres, 193 patients were included (mean age 68±9 years; 88% male; 53% non-ischaemic cardiomyopathy). Median follow-up was 19 months. Among 107 evaluable patients with ≥6-month follow-up, the median VT episode burden was reduced by 80% after STAR. Among patients surviving ≥6 months, 72% were free from implantable cardioverter-defibrillator (ICD) shock. In the full cohort, 12 SAEs were adjudicated as possibly or probably treatment-related, including pericardial effusion, coronary events, and early post-treatment ventricular arrhythmia. Overall survival probability was 77% at 12 months. Conclusions: In the largest prospective multicentre cohort reported to date, STAR was associated with a substantial reduction in VT burden and ICD shocks, with a low frequency of possibly or probably treatment-related SAEs.

Background: There are limited data on gender-based differences in atrial fibrillation (AF) treatment and prognosis. We aimed to examine gender-related differences in medical attention in an emergency department (ED) and follow-up (FU) among patients diagnosed with an AF episode and to determine whether there are gender-related differences in clinical characteristics, therapeutic strategies, and long-term adverse events in this population. Methods: We performed a retrospective observational study of patients who presented to a tertiary hospital ER for AF from 2010 to 2015, with a minimum FU of one year. Data on medical attention received, mortality, and other adverse outcomes were collected and analyzed. Results: Among the 2013 patients selected, 1232 (60%) were female. Women were less likely than men to be evaluated by a cardiologist during the ED visit (11.5% vs. 16.6%, p = 0.001) and were less likely to be admitted (5.9% vs. 9.5%, p < 0.05). Electrical cardioversion was performed more frequently in men, both during the first episode (3.4% vs. 1.2%, p = 0.001) and during FU (15.9% vs. 10.6%, p < 0.001), despite a lower AF recurrence rate in women (9.9% vs. 18.1%). During FU, women had more hospitalizations for heart failure (26.2% vs. 16.1%, p < 0.001). Conclusions: In patients with AF, although there were no gender differences in mortality, there were significant differences in clinical outcomes, medical attention received, and therapeutic strategies. Women underwent fewer attempts at cardioversion, had a lower probability of being evaluated by cardiologists, and showed a higher probability of hospitalization for heart failure. Being alert to these inequities should facilitate the adoption of measures to correct them.

Introduction and Objectives: The relationship between inflammation and atrial fibrillation (AF) has been poorly studied with common inflammatory markers and limited to analysing one or two markers. Given the large number of pathways in the inflammatory process and the complexity of their relationship with AF, we set out to study a broad panel of more specific biomarkers that attempt to cover as many inflammatory interactions and mechanisms as possible. Our objetive was to evaluate which biomarkers were elevated in AF patients compared to the general population. Methods: We studied 74 patients who were to undergo an ablation procedure (53 with AF and 21 controls -microscopic substrates-), drawing a blood sample before the procedure. Exclusion criteria were: cancer, inflammatory diseases, heart failure or major echocardiographic alterations including mild ventricular hypertrophy. Baseline characteristics, basic analytical parameters and levels of 20 specific inflammatory biomarkers were collected and compared in patients with and without AF. Results: Figure 1 shows the baseline characteristics of the sample. The usual analytical parameters in clinical practice showed no relevant differences between the two groups. Of the 20 specific inflammatory parameters, significant differences were found in 4: biomarkers of cardiomyocyte damage (NT-proBNP: (AF)130.8 +- 208.0 pg/mL vs (control) 80.3 +- 66.5 pg/mL; p=0.041), of atrial remodelling (Endostatin: 95.0 +- 28.8 ng/mL vs 80.1 +- 17.2 ng/mL; p<0.01), angiogenesis dysregulation (MCAM: 241.8 +- 51.9 ng/mL vs 197.1 +- 96.4 ng/mL; 0.033) and hepato-inflammatory cardiovascular risk markers (SAP; 7426.6 ± 2641.0 ng/mL vs 9406.9 ± 3904.1 ng/mL; p<0.011). In addition to these individual differences, multiple correspondance analysis (figure 2) allowed grouping most of the patients without arrhythmia using information from the biomarker set. Conclusions: In patients with AF, several specific parameters of inflammation are elevated compared to controls, supporting the presence of an activation of inflammation in these patients. Due to the large number of factors involved in the inflammatory process and the variability with which they can be activated, future research evaluating the clinical implication of these findings is essential.Baseline CharacteristicsMultiple correspondance analysis

Background: There is limited data on gender-based differences in atrial fibrillation (AF) treatment and prognosis. Our aim was to examine gender-related differences in medical attention in emergency department (ED) and follow-up (FU) among patients diagnosed with an AF episode and to determine whether there are gender-related differences in clinical characteristics, therapeutic strategies and long-term adverse events in this population. Methods: We performed a retrospective observational study of patients who presented to a tertiary hospital ER for AF from 2010-2015, with a minimum FU of one year. Data on medical attention received, mortality and other adverse outcomes were collected and analyzed. Results: Among the 2 013 patients selected, 1232 (60%) was female. Women were less likely than men to be evaluated by a cardiologist during the ED visit (11.5% vs. 16.6%, p=0.001) and were less likely to be admitted (5.9% vs. 9.5%, p<0.05). Electrical cardioversion was performed more frequently in men, both during the first episode (3.4% vs. 1.2%, p=0.001) and during FU (15.9% vs. 10.6%, p<0.001), in spite of a lower AF recurrence rate in women (9.9% vs 18.1%). During FU, women had more hospitalizations for heart failure (26.2% vs. 16.1%, p<0.001). Conclusions: In patients with AF, although no gender differences in mortality, there were significant differences in clinical outcomes, medical attention received, and therapeutic strategies. Women underwent fewer attempts at cardioversion, had a lower probability of being evaluated by cardiologists and showed a higher probability of hospitalization for heart failure. Being alert to these iniquities should facilitate to adopt measures to correct them.