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

Abstract

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.

Catastrophic left atrial tear during cryoballoon pulmonary vein isolation following chemotherapy

“…Garibaldi and colleagues 7 recently published a review of PVI outcomes in patients with cancer. Although outcomes and complication rates were comparable to the general population, the 5 reviewed studies collectively included <300 patients and represented only a small subset of cancer types, with breast and genitourinary cancers being among the most represented.…”