Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-173 - Incidence And Outcomes Of Atrial Fibrillation Among Patients Undergoing Chemotherapy In The United States (ID 127)

 K. Quelal: Nothing relevant to disclose.
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Background: Cancer chemotherapy (CC) continues to be an important aspect of malignancies management. Several neoplastic malignant conditions are more prevalent in older people with a concomitant increase in cardiovascular risk factors in this population. Chemotherapeutic agents can be arrhythmogenic even below toxic doses. Atrial fibrillation (AF) is by far the most common arrhythmia that the heart resorts to when under stress.
Objective: We sought to describe the incidence, predictors, and outcomes of atrial fibrillation among patients admitted for chemotherapy.
Methods: We queried the National Inpatient Sample (NIS) databases from 2007 to 2014 for adults aged 18 and above admitted to an encounter for antineoplastic chemotherapy as reported by the ICD-9 codes V58.1, V58.11, V58.12. We identified patients who had atrial fibrillation documented during the admission. Categorical and continuous variables were compared using Chi-square and Student's t-test. Predictors of atrial fibrillation and in-hospital mortality were evaluated by logistic regression.
Results: 125002 patients were admitted for inpatient chemotherapy between 2010 and 2014 which corresponds to 620925 weighted cases. 42.7 % were found to be females and atrial fibrillation occurred in 3.9% of the patient population. Risk factors for AF development include: advancing age aOR: 25.5 (95% CI 23.1 - 28.1) for patients greater than 80 years and aOR: 15 (95% CI 13.7 - 16.4) for patients 65 to 79 years compared to patients aged 18 to 44; male sex aOR: 1.57 (95% CI 1.51 - 1.62); HTN aOR: 1.22 (95% CI 1.18 - 1.27); OSA aOR: 2.08 (95% CI 1.92 - 2.26); and CHF aOR: 1.98 (95% CI 1. 86 - 2.11). Patients with AF were more likely to have increased length of stay (LOS) mean: 8.3 days and have a higher cost of hospitalization (mean 60,289 USD) compared to 5.6 days and 42,682 USD in patients without atrial fibrillation respectively. AF was associated with higher mortality aOR: 3.80 (95% CI 3.47 - 4.17) compared to those without.
Conclusion: Atrial fibrillation can occur in patients undergoing chemotherapy and it is associated with worse outcomes. Management of AF in this patient population is challenging especially given the potential for important drug interaction and increased bleeding risk in these patients.