Catheter Ablation Outcomes for Atrial Arrhythmias in Breast Cancer

ObjectivesThe aim of this study was to assess the safety and efficacy of catheter ablation for atrial arrhythmias in breast cancer patients.BackgroundBreast cancer patients undergo various therapies such as surgical intervention, radiation therapy, and chemotherapy which may lead them to be at increased procedural risk compared to non-cancer patients. Catheter ablation in breast cancer patients is not well studied. MethodsConsecutive patients with breast cancer undergoing ablation for atrial fibrillation and atrial flutter from January 2010 to November 2020 at Mayo Clinic were propensity matched in a 1:1 ratio to patients with no history of any cancer. The primary outcome for safety was a composite endpoint of eight post-ablation complications, including the development of cardiac tamponade, pericarditis, phrenic nerve damage, atrioesophageal fistulas, stroke, MI, clinically relevant bleeding, and post-ablation infections. Efficacy outcomes included symptomatic improvement, recurrent arrhythmias, and the need for repeat ablations.ResultsOverall, 41 female patients with breast cancer and 41 female patients with no history of cancer were included. Both groups had similar echocardiographic, baseline, and arrhythmia characteristics. They had similar mapping (p=0.38), ablation (p=0.74), energy delivery (p=0.87), and total procedure times (p=0.67). Breast cancer patients were at increased risk of post-ablation complications (43.9% vs 9.76%, p<0.05) driven by a higher risk of bleeding (p=0.03) and with a worse survival post-ablation albeit non-cardiac etiology (p=0.30). ConclusionIn a propensity matched cohort, we found breast cancer patients have an increased risk of developing complications post-ablation, in particular a higher risk of clinically relevant bleeding.