Objective: To analyze the impact of cancer on the recurrence rate of atrial fibrillation (AF) after AF radiofrequency ablation and further evaluate the feasibility of radiofrequency ablation therapy in cancer patients with AF. Methods: This study was a single-center, retrospective study. Cancer patients with AF undergoing radiofrequency ablation for the first time in the First Affiliated Hospital of Dalian Medical University from May 30, 2008 to September 30, 2018 were included (cancer group). AF patients without cancer undergoing radiofrequency ablation for the first time during the same period served as non-cancer group. Clinical data including age, gender, past history, cancer and AF-related parameters, etc. were analyzed. Patients were followed up after radiofrequency ablation. The primary endpoints were AF recurrence or all-cause death. Kaplan-Meier survival analysis was used to analyze the effect of cancers on the recurrence after AF ablation. The multivariate cox regression analysis was further applied to correct for other confounding factors to analyze whether the impact of cancers on the recurrence of atrial fibrillation was statistically significant. Results: A total of 90 patients were enrolled, there were 30 patients in the cancer group (mean age (64.8±6.6) years, 16 (53.3%) males) and 60 patients in the non-cancer group (mean age (63.6±6.2) years, 32 (53.3%) males). Clinical data, such as age, gender, and cancer treatment, were similar between the two groups. During an average follow-up period of (328.7±110.2) days, there were 6 AF recurrences (recurrence rate 20.0%) in the cancer group, and 17 AF recurrences (recurrence rate 28.3%) in the control group. AF recurrence rate was similar between the two groups (P>0.05). During the follow-up period, there was no all-cause death in the two groups. Kaplan-Meier survival analysis showed that cancer was not related to AF recurrence after radiofrequency ablation (P = 0.383). After adjusting for other confounding factors, the multivariate Cox regression analysis showed that cancer was not an independent predictor of AF recurrence after radiofrequency ablation (HR=0.508, 95%CI: 0.192-1.342, P = 0.172). Conclusions: The combination of cancer has no impact on the recurrence of AF after radiofrequency ablation. For cancer patients with AF, radiofrequency ablation therapy can be considered as a feasible heart rhythm control treatment strategy.
目的： 分析罹患恶性肿瘤对心房颤动（房颤）射频消融术后房颤复发率的影响，探讨射频消融用于恶性肿瘤患者的可行性。 方法： 本研究为一项单中心的回顾性研究，选取2008年5月30日至2018年9月30日于大连医科大学附属第一医院首次行射频消融治疗的恶性肿瘤合并房颤患者，设置为肿瘤组。选取同时期既往无恶性肿瘤病史且首次行射频消融治疗的房颤患者设置为对照组。收集患者的临床资料，包括年龄、性别、既往史、肿瘤和房颤相关指标等。射频消融术后对患者进行随访，随访终点为房颤复发或全因死亡。采用Kaplan-Meier生存分析模型分析恶性肿瘤对射频消融术后房颤复发的影响。校正混杂因素后，进一步采用多因素Cox回归分析恶性肿瘤对房颤复发的影响。 结果： 共纳入90例患者，其中肿瘤组30例，年龄（64.8±6.6）岁，男性16例（53.3%）。对照组60例，年龄（63.6±6.2）岁，男性32例（53.3%）。2组患者的年龄、性别、肿瘤治疗情况等临床资料比较差异均无统计学意义。随访（328.7±110.3）d，肿瘤组房颤复发6例（复发率20.0%），对照组房颤复发17例（复发率28.3%），2组患者房颤复发率差异无统计学意义。随访期间内2组均未出现全因死亡。Kaplan-Meier生存分析结果显示，是否罹患恶性肿瘤对射频消融术后房颤复发率无影响（P=0.383）。多因素Cox回归分析提示，校正其他混杂因素后，罹患恶性肿瘤与射频消融术后房颤复发之间仍无相关性（HR=0.508，95%CI 0.192~1.342，P=0.172）。 结论： 罹患恶性肿瘤对射频消融术后房颤复发无影响。对于合并房颤的恶性肿瘤患者，射频消融治疗可视为一种可行的心脏节律控制治疗策略。.