Atrial Fibrillation Catheter Ablation among Cancer Patients: Utilization Trends and In-Hospital Outcomes

BACKGROUND: Atrial fibrillation (AF) catheter ablation in cancer patients was evaluated in very few studies. We aimed to investigate trends of utilizations as well as in-hospital outcomes of AF catheter ablation procedures among cancer patients, in a large inpatient US registry. METHODS AND RESULTS: Using the National Inpatient Sample (NIS) database, patients who underwent AF catheter ablations in the US between 2012 and 2019 were identified using ICD-9/10 codes. Sociodemographic, clinical data, in-hospital procedures and outcomes as well as in-hospital mortality and length-of-stay (LOS) were collected. Baseline characteristics and in-hospital outcomes were compared between patients with and without cancer. An estimated total of 67915 patients underwent AF catheter ablation between 2012-2019 in the US. Of them, 950 (1.4%) had cancer diagnosis. Compared with non-cancer patients, patients with cancer were older, had higher Charlson Comorbidity Index, as well as CHA2DS2-VASc and ATRIA bleeding indices scores. Higher rate of total complications was observed in cancer patients (10.5% vs 7.9, p<0.001) driven mainly by more bleeding and infectious complications. LOS was also significantly longer in cancer patients (4.9 ± 5.8 vs. 2.7 ± 3.0 days, p<0.001). However, no significant differences in cardiac or neurological complications as well as in-hospital mortality rates were observed and were relatively low in both groups. CONCLUSIONS: AF catheter ablation in cancer patients is associated with higher bleeding and infectious complication rates, but not with increased cardiac complications or in-hospital mortality rates in a nationwide, all-comer registry.