Table 2.
Studies analysing the safety and efficacy of catheter ablation in patients with cancer
| Study (years) | Study design | Patients (n) | History of cancer/active cancer (n) | Age (mean) | Female (%) | Type of cancer (%) | Primary outcome | Results and conclusion | Follow-up(months) |
|---|---|---|---|---|---|---|---|---|---|
| Giustozzi et al.13 (2021) | Retrospective single centre | 184 | 21/- | 64.3 | 33.0 | Gastrointestinal (36%), breast (23%), and genitourinary (18%) | Clinically relevant bleeding, defined as the composite of major and clinically relevant non-major bleedings observed during 30 ± 5 days after the catheter ablation procedure. | Clinically relevant bleeding after catheter ablation for AF is more frequent in cancer survivors than in patients without cancer | 1 |
| Eitel et al.14 (2021) | Retrospective single centre | 140 | 62/8 | 71.3 | 44.3 | Genitourinary cancer (30%), breast cancer (28.6%), haemato-oncologic cancer (12.9%), gastrointestinal cancer (11.4%), head or neck cancer (5.7%), and lung cancer (2.9%) | Complications were defined as periprocedural when occurring intra-procedural, post-procedural during the hospital stay or until 30 days after the procedure. Complications were classified as major complications if permanent injury, interventional treatment, prolonged hospital stay, repeat hospitalization for more than 48 h, or death occurred, as described in the consensus statement for catheter ablation of AF. Bleeding complications were classified as described in the criteria of the International Society on Thrombosis and Haemostasis as major bleeding or clinically relevant non-major bleeding. | High arrhythmia-free survival with low frequencies of periprocedural complications was observed in patients with a history of cancer undergoing cryo-balloon ablation. Procedural safety and arrhythmia-free survival were comparable to patients without cancer disease. | 12 |
| Ganatra et al.11 (2023) | Retrospective single centre | 502 | 205/46 | 65.5 | 50.0 | Breast cancer (29.9%), lung cancer (6.0%), prostate cancer (22.3%), lymphoma (10.0%), and other cancer (31.9%) | Freedom from atrial fibrillation (with or without anti-arrhythmic drugs or need for repeat ablation) at 12 months post-ablation in patients with a history of cancer compared to controls. | The success rate, defined as freedom from recurrent AF, with or without AAD, and the need for repeat ablation at 12 months post-ablation, in patients with cancer was similar to that observed in non-cancer controls. At the same time, safety outcomes, including post-procedural bleeding, pulmonary vein stenosis, stroke, and cardiac tamponade within the first 3 months after catheter ablation, were also similar to non-cancer controls. | 12 |
| Thotamgari et al.10 (2023) | Retrospective multi-centre | 47 765 | 750/- | 67.1 | 42.0 | Haematological malignancy (60%), respiratory tract (16%), gastrointestinal (12%), breast (6%), and urinary tract (6%) | Mortality, major periprocedural cardiac complications including acute heart failure, acute myocardial infarction, cardiac arrest, cardiogenic shock, acute pericarditis, heart block, major bleeding, retroperitoneal bleeding, pulmonary embolism, and acute kidney injury. | Patients with cancer undergoing catheter ablation for atrial fibrillation had significantly higher odds of in-hospital mortality, major bleeding, and pulmonary embolism as compared to those without cancer. | In-hospital stay |