https://orcid.org/0000-0003-4603-2510
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ABSTRACT
Background
Atrial fibrillation (AF) is the most common arrhythmia in patients with cancer, especially breast, gastrointestinal, respiratory, urinary tract, and hematological malignancies. Catheter ablation (CA) is a well-established, safe treatment option in healthy patients; however, literature regarding safety of CA for AF in patients with cancer is limited and confined to single centers.
Objective
We aimed to assess the outcomes and peri-procedural safety of CA for AF in patients with certain types of cancer.
Methods
The NIS database was queried between 2016 and 2019 to identify primary hospitalizations with AF and CA. Hospitalizations with secondary diagnosis of atrial flutter and other arrhythmias were excluded. Propensity score matching was used to balance the covariates between cancer and non-cancer groups. Logistic regression was used to analyze the association.
Results
During this period, 47,765 CA procedures were identified, out of which 750 (1.6%) hospitalizations had a diagnosis of cancer. After propensity matching, hospitalizations with cancer diagnosis had higher in-hospital mortality (OR 3.0, 95% CI 1.5–6.2, p = 0.001), lower home discharge rates (OR 0.7, 95% CI 0.6–0.9, p < 0.001) as well as other complications such as major bleeding (OR 1.8, 95% CI 1.3–2.7, p = 0.001) and pulmonary embolism (OR 6.1, 95% CI 2.1–17.8, p < 0.001) but not associated with any major cardiac complications (OR 1.2, 95% CI 0.7–1.8, p = 0.53).
Conclusion
Patients with cancer who underwent CA for AF had significantly higher odds of in-hospital mortality, major bleeding, and pulmonary embolism. Further larger prospective observational studies are needed to validate these findings.
Abbreviations
| AF | = | atrial fibrillation |
| AKI | = | acute kidney injury |
| CA | = | catheter ablation |
| CI | = | confidence interval |
| ICD | = | International classification of diseases |
| MI | = | myocardial infarction |
| NIS | = | national inpatient sample |
| aOR | = | adjusted odds ratio |
| PCI | = | percutaneous coronary intervention |
| PE | = | pulmonary embolism |
| TIA | = | transient ischemic attack |
Acknowledgments
This report was presented as a poster presentation for the national Heart Rhythm Society conference, in April 2022.
Declaration of financial/other relationships
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
SR Thotamgari, AR Sheth: conceptualization, data curation, formal analysis, methodology, original draft; HP Patel, H Sandhyavenu, B Patel, US Grewal: writing – original draft; MN Bhuiyan: formal analysis, software; SS Dani, P Dominic: conceptualization, funding acquisition, investigation, methodology, resources, supervision, validation, writing-review & editing. CRediT roles: Conceptualization; Data curation; Formal analysis; Funding acquisition; Investigation; Methodology; Project administration; Resources; Software; Supervision; Validation; Visualization; Roles/Writing – original draft; Writing – review & editing.
Supplemental data
Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2023.2218188