Catheter Ablation in Patients With Neuroendocrine (Carcinoid) Tumors and Carcinoid Heart Disease

Shabtaie, Samuel A.; Luis, Sushil Allen; Ward, Robert C.; Karki, Roshan; Connolly, Heidi M.; Pellikka, Patricia A.; Kapa, Suraj; Asirvatham, Samuel J.; Packer, Douglas L.; DeSimone, Christopher V.

doi:10.1016/j.jacep.2020.08.009

Cited by 9 publications

(14 citation statements)

References 26 publications

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“…Of them, ten had a history of lung cancer, and 80% were free from AF recurrence at 1 year of follow‐up without using antiarrhythmic agents. Likewise, the first‐year recurrence rate was approximately 20%–30% from the non‐cancer population 18,19 . The results of these works indicated a similar success rate for pulmonary vein isolation between patients receiving cancer treatment and patients without a cancer history 13 .…”

Section: Discussionmentioning

confidence: 85%

“…Likewise, the first-year recurrence rate was approximately 20%-30% from the noncancer population. 18,19 The results of these works indicated a similar success rate for pulmonary vein isolation between patients receiving cancer treatment and patients without a cancer history. 13 Another study reported that 67.1% of cancer patients were free from AF compared to 77.8% of non-cancer patients, which was clinically significant even though the statistical significance was not achieved (p = .16).…”

Section: Discussionmentioning

confidence: 86%

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Outcome of cancer patients after atrial fibrillation ablation: Insights from the China‐AF registry

Peng,

He,

Liu

et al. 2023

Pacing Clinical Electrophis

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BackgroundCancer has become significant comorbidity in patients with atrial fibrillation (AF). However, little is known about the efficacy and safety of AF ablation, the first‐line rhythm control strategy, in patients with cancer. This study aims to evaluate the incidence and risk of AF recurrence and safety endpoints in patients with cancer compared to the non‐cancer group after ablation.MethodsFrom August 2011 to December 2020, we consecutively enrolled cancer patients in the China‐AF cohort. We used propensity score matching (1:3) to select the control group and assessed the risk of AF recurrence and adverse events after ablation in cancer patients using a multivariable Fine and Gray competing risk model.ResultsA total of 203 patients with cancer were enrolled and 21 of them were active cancer, with a median follow‐up of 12.3 months. The cumulative incidence of AF recurrence was comparable between patients with and without cancer (43.8% vs. 51.1%; p = .88). No difference in the risk of AF recurrence, thromboembolism, major bleeding, and mortality was observed after adjusting confounders. Active cancer was not associated with an increased risk of AF recurrence compared to the stable disease (SHR = 1.32; 95% CI 0.72–2.43; p = .46). Cancer was associated with a low risk of cardiovascular hospitalization (SHR, 0.54; 95% CI, 0.36–0.81; p = .01). Subgroup analysis found that hematological malignancy was associated with a high risk of AF recurrence (SHR, 5.68; 95% CI, 3.00–10.8; p < .001).ConclusionsThis study suggests that catheter ablation could be feasible for rhythm control of AF patients with concomitant cancer.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 86%

Outcome of cancer patients after atrial fibrillation ablation: Insights from the China‐AF registry

Peng,

He,

Liu

et al. 2023

Pacing Clinical Electrophis

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“…In the case of intolerance or resistance to anti-arrhythmic medication treatment, catheter ablation has recently been investigated as a possible therapeutic alternative. Actually, the ablation therapy in patients with AF and cancer is not well-defined, and the few available data are conflicting [ 64 , 65 ].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Shabtaie et al [ 64 ] demonstrated the viability of performing atrial fibrillation ablation procedures (23% of arrythmias) in patients with neuroendocrine tumors, including those with metastatic disease, carcinoid syndrome, and carcinoid heart disease. Despite promising findings on the use of PVI in cancer patients, these studies have some limitations: Firstly, the sample of patients analysed is rather limited, with only a few tumour types being analysed.…”

Section: Pulmonary Vein Isolation (Pvi) Ablationmentioning

confidence: 99%

Treatment Options in AF Patients with Cancer; Focus on Catheter Ablation

Garibaldi

Chianca

Fabiani

et al. 2022

JCM

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Longer life expectancy along with advancements in cancer and atrial fibrillation (AF) therapies and treatment strategies have led to an increase in the number of individuals with both diseases. As a result, the complicated management of these patients has become crucial, necessitating individualised treatment that considers the bi-directional relationship between these two diseases. On the one hand, giving appropriate pharmaceutical therapy is exceptionally difficult, considering the recognised thromboembolic risk posed by AF and malignancy, as well as the haemorrhagic risk posed by cancer. The alternative pulmonary vein isolation (PVI) ablation, on the other hand, has been inadequately explored in the cancer patient population; there is yet inadequate data to allow the clinician to unambiguously select patients that can undertake this therapeutic intervention. The goal of this review is to compile the most valuable data and supporting evidence about the characteristics, care, and therapy of cancer patients with AF. Specifically, we will evaluate the pharmaceutical options for a proper anticoagulant therapy, as well as the feasibility and safety of PVI in this population.

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“…One study so far has demonstrated the feasibility of catheter ablation of atrial and ventricular tachyarrhythmias in a cohort of 17 patients with neuroendocrine tumors. Only two of these patients had carcinoid heart disease, and their treated arrhythmia has not been described [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Ablation of typical atrial flutter as therapeutic component in carcinoid heart disease: a case report

et al. 2022

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Background Carcinoid heart disease is the cardiac manifestation of carcinoid syndrome. There is limited research on rhythm management in patients with carcinoid heart disease. The association of typical atrial flutter and carcinoid heart disease in particular is poorly described. Case presentation Here we present a case of a 77-year-old German woman with carcinoid heart disease and recurrent typical atrial flutter complicating the postoperative course after tricuspid valve replacement and its successful long-term rhythm control by ablation therapy. Conclusion There is limited evidence on rhythm management in patients with the rare diagnosis of carcinoid heart disease. Typical atrial flutter repeatedly complicated the postoperative course of our patient with carcinoid heart disease and could finally be treated curatively by ablation. Radiofrequency ablation should be considered as a valuable therapeutic component in the challenging therapy of this disease.

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Catheter Ablation in Patients With Neuroendocrine (Carcinoid) Tumors and Carcinoid Heart Disease

Cited by 9 publications

References 26 publications

Outcome of cancer patients after atrial fibrillation ablation: Insights from the China‐AF registry

Outcome of cancer patients after atrial fibrillation ablation: Insights from the China‐AF registry

Treatment Options in AF Patients with Cancer; Focus on Catheter Ablation

Ablation of typical atrial flutter as therapeutic component in carcinoid heart disease: a case report

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