Key result
Cancer patients undergoing left atrial appendage occlusion for atrial fibrillation had a significantly higher risk of short-term mortality compared to non-cancer patients (RR 2.07).
Why the study?
There is an ongoing debate regarding the safety and efficacy of left atrial appendage occlusion for atrial fibrillation in patients with cancer.
Does left atrial appendage occlusion have different safety and efficacy outcomes in cancer patients compared to non-cancer patients with atrial fibrillation?
Meta-Analysis (n=61,522)
Does left atrial appendage occlusion have different safety and efficacy outcomes in cancer patients compared to non-cancer patients with atrial fibrillation?
Relative Risk: 2.07 (95% CI 1.12–3.84)
p-value: p=0.02
Left atrial appendage occlusion in cancer patients is associated with a significantly higher risk of short-term mortality and pericardial complications compared to non-cancer patients, though the risks of ischemic stroke, bleeding, and device complications are similar.
Cancer patients face higher short-term mortality and pericardial complications after LAAO; extends observational evidence and supports individualized selection pending randomized data.
There is an ongoing debate regarding the safety and efficacy of left atrial appendage occlusion (LAAO) for atrial fibrillation in patients with cancer. We searched PubMed and Scopus from the database's inception until November 2024 and included studies comparing cancer patients with non-cancer patients undergoing left atrial appendage closure for atrial fibrillation. Our primary outcome was short-term mortality. Secondary outcomes were ischemic stroke, major bleeding, device complications, and pericardial complications. For the dichotomous outcomes, risk ratios (RR) were used, whereas generic inverse variance (GIV) was used to pool the RRs and corresponding 95% confidence interval (95% CI). A random effects model was used to evaluate all the outcomes. Our analysis showed a significantly higher rate of short-term mortality in patients with cancer as compared to non-cancer patients (RR=2.07; 95% CI [1.12 to 3.84]; p=0.02). From secondary outcomes, pericardial complications showed a significantly higher risk in cancer patients (RR: 2.17, 95% CI [1.51, 3.12]; p<0.0001). Meanwhile, other secondary outcomes were found to be insignificant. LAAO in cancer patients was significantly associated with higher short-term mortality and pericardial complications.
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Ahmed et al. (2025) conducted a meta-analysis in Atrial fibrillation (n=61,522). Cancer vs. Non-cancer patients was evaluated on Short-term mortality (RR 2.07, 95% CI 1.12 to 3.84, p=0.02). Cancer patients undergoing left atrial appendage occlusion for atrial fibrillation had a significantly higher risk of short-term mortality compared to non-cancer patients (RR 2.07).
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