Sahith Reddy Thotamgari, Aakash R Sheth, Harsh P Patel, Harigopal Sandhyavenu, Bhavin Patel, Udhayvir S Grewal, Mohammad Alfrad Nobel Bhuiyan, Sourbha S Dani, Paari Dominic
{"title":"Safety of catheter ablation for atrial fibrillation in patients with cancer: a nationwide cohort study.","authors":"Sahith Reddy Thotamgari, Aakash R Sheth, Harsh P Patel, Harigopal Sandhyavenu, Bhavin Patel, Udhayvir S Grewal, Mohammad Alfrad Nobel Bhuiyan, Sourbha S Dani, Paari Dominic","doi":"10.1080/00325481.2023.2218188","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>We aimed to assess the outcomes and peri-procedural safety of CA for AF in patients with certain types of cancer.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.001), lower home discharge rates (OR 0.7, 95% CI 0.6-0.9, <i>p</i> < 0.001) as well as other complications such as major bleeding (OR 1.8, 95% CI 1.3-2.7, <i>p</i> = 0.001) and pulmonary embolism (OR 6.1, 95% CI 2.1-17.8, <i>p</i> < 0.001) but not associated with any major cardiac complications (OR 1.2, 95% CI 0.7-1.8, <i>p</i> = 0.53).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":20329,"journal":{"name":"Postgraduate Medicine","volume":"135 6","pages":"562-568"},"PeriodicalIF":2.6000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Postgraduate Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/00325481.2023.2218188","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 2
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.
背景:心房颤动(AF)是癌症患者最常见的心律失常，尤其是乳腺癌、胃肠道、呼吸系统、泌尿系统和血液系统恶性肿瘤。导管消融(CA)在健康患者中是一种成熟、安全的治疗选择;然而，关于CA治疗AF癌症患者安全性的文献是有限的，并且仅限于单一中心。目的:我们旨在评估CA治疗某些类型癌症患者AF的预后和围手术期安全性。方法:查询NIS数据库，确定2016 - 2019年因房颤和房颤住院的患者，排除继发诊断为心房扑动和其他心律失常的住院患者。倾向评分匹配用于平衡癌症组和非癌症组之间的协变量。采用Logistic回归分析相关性。结果:在此期间，确定了47,765例CA手术，其中750例(1.6%)住院诊断为癌症。倾向匹配后，诊断为癌症的住院患者有较高的住院死亡率(OR 3.0, 95% CI 1.5-6.2, p = 0.001)，较低的出院率(OR 0.7, 95% CI 0.6-0.9, p = 0.001)和肺栓塞(OR 6.1, 95% CI 2.1-17.8, p = 0.53)。结论:因房颤而行CA的癌症患者住院死亡率、大出血和肺栓塞的几率明显更高。需要进一步更大规模的前瞻性观察研究来验证这些发现。
期刊介绍：
Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916, Postgraduate Medicine was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
