Catheter Ablation for Atrial Fibrillation in Breast Cancer Survivors: An Exploratory Observational Study Using the French Nationwide Health Care Database Sample

IF 1.9 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-08-25 DOI:10.1002/cnr2.70320

Laura Saint-Lary, Juliette Thariat, Baptiste Pinel, Gaëlle Jimenez, Marie-Odile Bernier, Loïc Panh, Serge Boveda, Sophie Jacob

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Abstract

Background

Catheter ablation is a key treatment for atrial fibrillation (AF). This procedure is clearly identifiable in French medical-administrative databases and can be used as a surrogate for symptomatic patients with drug-refractory or symptomatic paroxysmal AF forms. Breast cancer (BC) patients have an increased risk of AF, but knowledge about AF forms treated by ablation is limited.

Aims

Based on a representative cohort of BC patients from the French National Health Databases, we aimed to assess the occurrence of AF catheter ablation in these patients, compared to the general population.

Methods

Patients with a first diagnosis of BC between 2008 and 2018 and followed for at least 1 year until 2019 were eligible. The incidence rates of AF ablation among BC patients were compared to those in the general population by estimating a standardized incidence ratio (SIR). A competing risk survival model was used to evaluate the occurrence of AF ablation in BC patients treated with or without radiotherapy (RT) (subdistribution Hazard Ratio—sdHR).

Results

We included 3667 patients (78% with RT). Overall, 16 cases underwent AF ablation, whereas 8.3 cases were expected in the general population, resulting in a significant SIR of 1.93 [1.10–3.00] (p < 0.05). After a mean follow-up of 6.6 years, the cumulative incidence of AF ablation at 5 years was 0.14% [0.05–0.35] in the RT group and 0.47% [0.13–1.31] in the non-RT group, with no significant difference in the age-adjusted survival analysis (sdHR = 0.65 [0.21–2.01]).

Conclusions

Our exploratory study revealed that BC patients had a twofold greater rate of first AF ablation than the age-comparable general population, without a link with RT. These results should be interpreted cautiously because of the limited size of the study population and the differing characteristics between the RT and non-RT groups.

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导管消融治疗乳腺癌幸存者心房颤动：一项使用法国全国卫生保健数据库样本的探索性观察研究

导管消融是房颤（AF）的关键治疗方法。该方法在法国医疗管理数据库中可明确识别，可作为药物难治性或症状性阵发性房颤症状患者的替代方法。乳腺癌（BC）患者发生房颤的风险增加，但有关房颤消融治疗的知识有限。基于来自法国国家健康数据库的代表性BC患者队列，我们旨在评估与普通人群相比，这些患者房颤导管消融的发生率。方法2008 - 2018年间首次诊断为BC并随访至少1年至2019年的患者入选。通过估计标准化发生率（SIR），将BC患者的房颤消融发生率与普通人群的发生率进行比较。竞争风险生存模型用于评估接受或未接受放疗的BC患者房颤消融的发生率（亚分布风险比- sdhr）。结果我们纳入了3667例患者（78%为RT）。总体而言，16例患者接受了房颤消融治疗，而在普通人群中预期为8.3例，SIR为1.93 [1.10-3.00]（p < 0.05）。平均随访6.6年，5年房颤消融累积发生率在放疗组为0.14%[0.05-0.35]，在非放疗组为0.47%[0.13-1.31]，年龄校正生存分析无显著差异（sdHR = 0.65[0.21-2.01]）。结论：我们的探索性研究显示，BC患者的首次房颤消融率比同龄普通人群高两倍，与RT无关。由于研究人群的规模有限，RT组和非RT组之间的特征不同，这些结果应谨慎解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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