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B-PO03-118 ATRIAL ARRHYTHMIA ABLATION OUTCOMES IN BREAST CANCER PATIENTS

      Background

      Atrial arrhythmias are increasingly prevalent but the safety and efficacy in breast cancer patients has not been studied.

      Objective

      To assess the safety and efficacy of cardiac ablation in patients with breast cancer.

      Methods

      Consecutive patients with a history of breast cancer undergoing catheter ablation for atrial arrhythmias from January 2010 to November 2020 at Mayo Clinic were propensity matched in a 1:1 ratio to patients with no history of cancer using nine baseline characteristics. The primary outcome for safety was a composite endpoint of nine post-ablation complications including the development of hematomas, 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.

      Results

      Overall, 47 female patients with breast cancer and 47 female patients with no history of cancer were included. Both groups had statistically similar echocardiographic, baseline and arrhythmia characteristics. Both groups had similar mapping (p=0.24), ablation (p=0.96), energy delivery (p=0.86) and total procedure times (p=0.49). Breast cancer patients were at increased risk of post-ablation complications (38.3% vs 10.6%, p=0.002) driven by a higher risk of clinically relevant bleeding (p=0.02) and had a worse survival post-ablation (p=0.06).

      Conclusion

      Breast cancer patients have an increased risk of developing complications post-ablation with a higher risk of clinically relevant bleeding. However, they have similar procedural characteristics and efficacy outcomes.
      Tabled 1
      Safety and Efficacy of Ablation in Breast Cancer Patients
      Breast Cancer Patients (n= 47)Non-Cancer patients (n=47)P Value
      Age at Arrhythmia DiagnosisMean (SD)71.0 (11.9)71.3 (10.7)0.89
      Age at Atrial AblationMean (SD)76.2 (9.45)75.9 (8.18)0.85
      Follow-Up Length (Years)Mean (SD)10.0 (6.32)8.9 (8.48)0.44
      CHA2-DS2-VAScMean (SD)5.28 (2.02)5.81 (1.94)0.20
      HAS-BLED ScoreMean (SD)4.38 (1.62)4.23 (1.54)0.65
      Composite Safety EndpointN (%)18 (38.3)5 (10.6)0.002
      Symptomatic ImprovementN (%)38 (80.9)38 (80.9)
      Recurrent Atrial ArrhythmiaN (%)11 (23.4)8 (17.0)0.47
      Repeat Ablation RequiredN (%)3 (6.4)2 (4.3)0.55