Arrhythmias & electrophysiologyCohort study
Predictors of Atrial Fibrillation After Thoracic Radiotherapy
- Retrospective cohort study
- single-centre
Authors' conclusion
PV dmax is a significant predictor of grade ≥3 AF regardless of underlying risk factors.
Study context
- Population
- Patients who underwent definitive radiotherapy for localized cancers (non-small cell lung, breast, Hodgkin lymphoma or esophageal), 2004–2022median follow-up 58.8 months
- Participants
- 539 patients
- Exposure
- Irradiation dose to cardiac substructures and risk of grade ≥3 atrial fibrillation (AF)
- Outcome
- Clinically significant (grade ≥3) AF
Main finding
As reported in the abstract
Predictors of grade ≥3 AF (competing risk models adjusted for MAFRS)
- Higher PV maximum dose (dmax)
- sHR 1.22; P < 0.001
- Larger left atrial volume
- sHR 1.01; P = 0.002
- Greater smoking history (pack-years)
- sHR 1.01; P = 0.010
- Higher Mayo AF risk score (MAFRS)
- sHR 1.16; P < 0.001
Observational data: associations, not effects.
Further findings
5-year cumulative incidence of AF, by cancer type
- Non-small cell lung cancer
- 11.1%
- Esophageal cancer
- 8.3%
- Breast cancer
- 1.3%
- Hodgkin lymphoma
- 0.8%
PV dmax across MAFRS subgroups
- PV dmax remained a significant predictor of AF across MAFRS subgroups
- PV dmax >39.7 Gy linked to higher AF risk, even when stratified by MAFRS
- P interaction = 0.11
Original publication
Predictors of Atrial Fibrillation After Thoracic Radiotherapy. JACC CardioOncol. Published 5 November 2024. doi:10.1016/j.jaccao.2024.08.007
Summarised from the published abstract; every number is checked against it