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.