Selection of rhythm intervention strategies in atrial fibrillation patients with cancer and efficacy and safety of catheter ablation

Xin Wang; Xu Han; Xiaolei Yang; Tesfaldet Habtemariam Hidru; Chengfang Wang; Yunlong Xia; Ying Che

doi:10.3389/fcvm.2024.1506143

Selection of rhythm intervention strategies in atrial fibrillation patients with cancer and efficacy and safety of catheter ablation

Front Cardiovasc Med. 2024 Nov 22:11:1506143. doi: 10.3389/fcvm.2024.1506143. eCollection 2024.

Authors

Xin Wang^{1

2}, Xu Han³, Xiaolei Yang⁴, Tesfaldet Habtemariam Hidru⁴, Chengfang Wang³, Yunlong Xia⁴, Ying Che¹

Affiliations

¹ Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
² Department of Ultrasound, The Affiliated Hospital of Innermongolia Medical University, Hohhot, China.
³ Health Management Center, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
⁴ Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.

Abstract

Background: The risk of comorbidity of cancer is increased in atrial fibrillation (AF) patients, which is a massive challenge for clinical management in cardiovascular settings. This study aimed to analyze whether cancer affects the decision of radiofrequency ablation and to explore the efficacy and safety of radiofrequency ablation in AF patients with cancer.

Methods: We conducted a retrospective cohort study of patients who were first diagnosed AF and identified who were with cancer. The propensity score matching method was utilized to balance the differences between the cancer and non-cancer groups. Logistic regression analysis was used to study the related factors affecting the ablation of AF. Cox regression analysis was used to evaluate the effect of cancer on the recurrence of AF after radiofrequency ablation.

Results: Among 9,159 patients who were first diagnosed AF, the prevalence of cancer was 4.48%. Cancer did not affect the decision of rhythm intervention in AF patients (P = 0.46). There was no significant difference in the incidence of perioperative complications, bleeding events, and embolization events between cancer and non-cancer groups (P = 1.000). The median follow-up time was 342 (293,866) days, and 45 patients had AF recurrence. Multivariable Cox regression showed no statistically significant relationship between concomitant cancer and AF recurrence after radiofrequency ablation (hazard ratio = 0.82, 95% confidence interval 0.36-1.83, P = 0.62).

Conclusions: The combination of cancer did not affect the decision of patients to perform ablation therapy. Radiofrequency catheter ablation could be used as a strategy to maintain long-term sinus rhythm in patients with concomitant cancer without affecting AF recurrence.

Keywords: atrial fibrillation; cancer; catheter ablation; recurrence; rhythm intervention.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by grants from the National Key Research and Development Program of China (grant number 2022YFC2405002), the First Affiliated of Dalian Medical University & Dalian Institute of Chemical Physics (grant number UN202201), the Dalian Science Fund for Distinguished Young Scholar (grant number 2022RJ13), the Dalian Talents Innovation Supporting Project (grant number 2022RQ095), and the Natural Science Foundation of Inner Mongolia Autonomous Region (grant number 2024QN08061).