Study On The Success Rate After Atrial Fibrillation Catheter Ablation In Cancer Survivors

Background: Due to the cancers and the toxic and side effects caused by anti-tumor treatment,cancer survivors have a higher incidence of atrial fibrillation(AF)which can seriously affect the quality of life of patients.Therefore,the clinical management strategy of AF in cancer survivors has become an important issue we will face.Based on the limitations of anticoagulant drugs and antiarrhythmic drugs in cancer survivors with AF,in order to improve the quality of life of patients,catheter ablation treatment can be considered as a possible treatment option.However,there is still no precise evidence to confirm the difference in the AF recurrence after catheter ablation between cancer survivors and patients without cancer.The success rate of catheter ablation in cancer survivors with AF is difficult to assess.Objective: The objective of this study is to compare the difference in AF recurrence after catheter ablation between cancer survivors and patients without cancer,and to analyze the effect of combination of cancer on the success rate after catheter ablation and further evaluate the efficacy and feasibility of catheter ablation therapy in cancer survivors with AF.Method: This study was designed as a single-center,retrospective study.We searched the Yidu Cloud database system of the First Affiliated Hospital of Dalian Medical University.All cancer survivors with AF undergoing radiofrequency catheter ablation for the first time were screened out from May 30,2008 to September 30,2018.Extracted patients with at least 3 months follow-up period after catheter ablation therapy and with complete baseline data as cancer group.And AF patients without cancer undergoing radiofrequency catheter ablation for the first time and matching the baseline data in observation group were screened out at 2: 1 ratio from the Yidu Cloud database.Extracted patients who were followed for at least 3 months after catheter ablation therapy and with complete baseline data as non-cancer group.The follow-up period is from the time of catheter ablation treatment to the time when AF recurrence or all-cause death occurred.Kaplan-Meier survival analysis and multivariate Cox regression analysis model were used for surival analysis.Kaplan-Meier survival analysis model was used to analyze the correlation between combined cancer and recurrence after AF ablation.Multivariate cox regression analysis was performed to correct for other confounding factors.P<0.05 was considered statistically significant.Results: A total of 90 patients were included in the study,of which 30 patients were in the cancer group and 60 patients were in the non-cancer group.During an average follow-up period of 328.72±110.28 days,a total of 23 recurrences of AF occurred after catheter ablation,including 6 recurrences of AF(recurrence rate 20.0%)among the 30 patients in the cancer group,and 17 recurrences of AF(recurrence rate 28.3%)among the 60 patients in the non-cancer group.Kaplan-Meier survival analysis showed that there was no significant effect of combination of cancer on the rate of AF recurrence after catheter ablation during the follow-up interval(Log-Rank test P = 0.383).After adjusting for other confounding factors,the multivariate Cox regression analysis showed that there was no statistical difference in the association between the combination of cancer and AF recurrence after catheter ablation(P = 0.172).The hazard ratio(HR)was 0.508(95% CI: 0.192-1.342).Conclusion: This study suggests that the combination of cancer has no significant effect on the recurrence of AF after catheter ablation.The results of this study show that for cancer survivors with AF,in order to achieve long-term sinus rhythm maintenance and improve patient quality of life,catheter ablation therapy can be considered as a feasible heart rhythm control treatment strategy.Catheter ablation could be an alternative treatment option especially for cancer survivors with long expected survival,long-term anticoagulant therapy intolerance,antiarrhythmic drug contraindications,or poor rhythm control with antiarrhythmic drugs.