iraf-ablation study: a multicenter international retrospective cohort of patients with btk inhibitors-related af treated by catheter ablation

Conditions: BTKi-induced Atrial Fibrillation; Hematologic Malignancy; Atrial Fibrillation Catheter Ablation

Summary: targeted anticancer drugs have completely changed the prognosis of malignancies during the past decades. patients suffering from malignancies live longer and this allows adverse events of anticancer drugs to emerge, notably cardiovascular adverse events. it is particularly important because of the great morbimortality of major cardiovascular events like myocardial infarction or stroke and because of their frequency in cancer populations. indeed, cardiovascular death is the second cause of deaths after malignancy itself in this population. atrial fibrillation (af) is a non rare cardiovascular adverse events associated with a shorter overall survival in some malignancies localization. the emblematic anticancer drugs promoting af is ibrutinib belonging to the bruton tyrosine kinase inhibitors (btki), which are indicated in hematological malignancies. incidence of af with ibrutinib is estimated to 4.92/100 person-years; 95% ci: 2.91-4.81 but is underestimated because of the absence of systematic electrocardiogram recording. the management of af rests on anticoagulation if indicated by the cha2ds2-vasc score, and on the choice between a rate or rhythm control strategy. rate control is the privileged strategy because of the risk of drugs interactions of the anti-arrhythmic drugs in a context of anticancer drugs co-prescriptions. but in case of symptoms with normal heart rate, life expectancy counted in years and preserved condition, catheter ablation has to be discussed. whereas this interventional procedure has been greatly studied in the general population, no study exists in patients with hematological malignancies. the investigators aim to describe baseline characteristics of a population of btki-induced af undergone af catheter ablation.

targeted anticancer drugs have completely changed the prognosis of malignancies during the past decades. patients suffering from malignancies live longer and this allows adverse events of anticancer drugs to emerge, notably cardiovascular adverse events. it is particularly important because of the great morbimortality of major cardiovascular events like myocardial infarction or stroke and because of their frequency in cancer populations. indeed, cardiovascular death is the second cause of deaths after malignancy itself in this population. atrial fibrillation (af) is a non rare cardiovascular adverse events associated with a shorter overall survival in some malignancies localization. the emblematic anticancer drugs promoting af is ibrutinib belonging to the bruton tyrosine kinase inhibitors (btki), which are indicated in hematological malignancies. incidence of af with ibrutinib is estimated to 4.92/100 person-years; 95% ci: 2.91-4.81 but is underestimated because of the absence of systematic electrocardiogram recording. the management of af rests on anticoagulation if indicated by the cha2ds2-vasc score, and on the choice between a rate or rhythm control strategy. rate control is the privileged strategy because of the risk of drugs interactions of the anti-arrhythmic drugs in a context of anticancer drugs co-prescriptions. but in case of symptoms with normal heart rate, life expectancy counted in years and preserved condition, catheter ablation has to be discussed. whereas this interventional procedure has been greatly studied in the general population, no study exists in patients with hematological malignancies. the investigators aim to describe baseline characteristics of a population of btki-induced af undergone af catheter ablation.

Eligibility criteria:
inclusion criteria: * every adult patient treated by btki for a hematological malignancy * with a new onset recurrence of af occurring after btki initiation and treated by catheter ablation * with an available 12 months follow up after catheter ablation exclusion criteria: * patients younger than 18 years old * severe mitral regurgitation/stenosis or rhumatismal heart disease whatever the grade * permanent af * patient who had af rhythm during the first administration of btki

Keywords: atrial fibrillation bruton tyrosine kinase inhibitors catheter ablation, atrial fibrillation recurrence