Safety of catheter ablation of atrial fibrillation in cancer survivors

• DOI: 10.1007/s10840-020-00745-7
• Publication Date: 2020-05-06T22:02:30Z
• Authors: Michela Giustozzi; Hussam Ali; Gianpaolo Reboldi; Cristina Balla; Sara Foresti; Guido de Ambroggi; Pier Paolo Lupo; Giancarlo Agnelli; Riccardo Cappato
• Keywords: Bleeding; Anticoagulants; Anticoagulation; Atrial fibrillation; Bleeding; Cancer; Catheter ablation; Atrial fibrillation; 3. Good health; Anticoagulation; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Cancer Survivors; Neoplasms; Atrial Fibrillation; Catheter Ablation; Humans; Catheter ablation; Cancer

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.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.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.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.