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Safety of catheter ablation of atrial fibrillation in cancer survivors

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Abstract

Purpose

In patients with cancer, the safety of catheter ablation for non-valvular atrial fibrillation (AF) has not been evaluated, yet. The aim of this study was to assess the safety of AF ablation in cancer survivors.

Methods

Consecutively recruited patients undergoing catheter ablation of non-valvular AF at our center between March 2015 and March 2017 were evaluated. The primary outcome of the study was clinically relevant bleedings occurred within 30 ± 5 days after the procedure. Patients with cancer were propensity matched to patients without cancer in a 1:3 and 1:6 ratio after stratification by baseline clinical features.

Results

Overall, 184 patients were included in the study. Of them, 21 (11%) were cancer survivors. Cancer site was more frequently gastrointestinal (36%), breast (23%), and genitourinary (18%). At 30 ± 5 days, clinically relevant bleedings occurred in 14 patients. Crude odds ratio (OR) for clinically relevant bleedings was 3.60 (95% CI 1.02–12.7) higher in cancer than in non-cancer patients. This trend remained after propensity score–matched population (OR 3.48, 95% CI 0.76–15.90 for matched 1:3, OR 4.95, 95% CI 1.2–20.2 for matched 1:6). Type of anticoagulation was not associated with bleedings.

Conclusions

Preliminary results suggest that clinically relevant bleeding after catheter ablation for AF is more frequent in cancer survivors than in patients without cancer. Further studies are required to confirm the present data.

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Author information

Authors and Affiliations

  1. Vascular and Emergency Medicine and Stroke Unit, University of Perugia, Perugia, Italy

    Michela Giustozzi & Giancarlo Agnelli

  2. Arrhythmia and Electrophysiology Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

    Hussam Ali, Sara Foresti, Guido de Ambroggi, Pier Paolo Lupo & Riccardo Cappato

  3. Italy Gavazzeni Hospital, Second Arrhythmia and EP Unit, Bergamo, Italy

    Hussam Ali, Sara Foresti, Guido de Ambroggi, Pier Paolo Lupo & Riccardo Cappato

  4. Department of Medicine, University of Perugia, Perugia, Italy

    Gianpaolo Reboldi

  5. Cardiovascular Institute, Azienda Ospedaliero-Universitaria S. Anna, Cona, FE, Italy

    Cristina Balla

Authors
  1. Michela Giustozzi
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  2. Hussam Ali
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  3. Gianpaolo Reboldi
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  4. Cristina Balla
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  5. Sara Foresti
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  6. Guido de Ambroggi
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  7. Pier Paolo Lupo
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  8. Giancarlo Agnelli
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  9. Riccardo Cappato
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Contributions

M. Giustozzi and H. Ali made a substantial contribution to the conception and design of the study, to the acquisition of data, to the analysis and interpretation of data, and to the drafting of the article. G. Reboldi made a substantial contribution to the analysis and interpretation of data and to the drafting of the article. C. Balla, S. Foresti, G. De Ambroggi, and P.P. Lupo made a substantial contribution to the acquisition of data and to the drafting of the article.

G. Agnelli and R. Cappato made a substantial contribution to the conception and design of the study, to the acquisition of data, to the analysis and interpretation of data, and to the critical revision of the manuscript for important intellectual content.

Corresponding author

Correspondence to Riccardo Cappato.

Ethics declarations

The study was approved by the Ethical Committee and Institutional Review Boards of our institution.

Conflict of interest

The authors declare that they have no conflict of interest.

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Highlights

• Atrial fibrillation (AF) in patients with cancer represents a clinical challenge.

• The management of AF in cancer patients has been scarcely evaluated.

• This is, to our knowledge, the first study on AF ablation in cancer patients.

• Cancer patients were propensity matched to non-cancer in a 1:3 and 1:6 ratio.

• Risk of bleeding was more frequent in cancer than non-cancer patients.

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Giustozzi, M., Ali, H., Reboldi, G. et al. Safety of catheter ablation of atrial fibrillation in cancer survivors. J Interv Card Electrophysiol 60, 419–426 (2021). https://doi.org/10.1007/s10840-020-00745-7

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  • DOI: https://doi.org/10.1007/s10840-020-00745-7

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