Early Rhythm Control Lowers Stroke Risk in Cancer Survivors With AF, suggests study
Researchers have indicated that early rhythm control (ERC) therapy significantly influences reducing the risk of ischemic stroke in cancer survivors with atrial fibrillation (AF), yielding strong evidence in favor of an intensive rhythm management approach in such at-risk patients. The study was published in the Journal of the American Heart Association by Seokmoon Han and fellow researchers. These findings emphasize the importance of incorporating ERC approaches in standard cardiovascular management among AF-presenting cancer survivors.
This population-based, large-scale observational study employed the Korean National Health Insurance Service database. Adults aged 20 years or older who were newly diagnosed with atrial fibrillation during 2009-2018 comprised the cohort. The patients were divided into two groups: the ERC group (which received rhythm control treatment within one year after diagnosis) and the usual care group (which received usual or rate-control-oriented treatment).
Researchers specifically examined outcomes in cancer survivors, those with a cancer diagnosis at least five years before the study, to see if early rhythm intervention was also beneficial for this population.
Out of the total number of 591,692 patients with AF, 18,747 (3.2%) were cancer survivors with a mean age of 65.7 years, and 53.7% of the study group were men. The participants were followed up for an average duration of four years to track the occurrence of ischemic stroke, adjusting the results for variables such as age, comorbidities, race, and complications at the time of AF diagnosis.
Key Findings
• Total participants: 591,692
• Cancer survivors: 18,747 (3.2%)
• Mean age of participants: 65.7 years
• Gender distribution: Male 53.7%Follow-up duration: Mean 4 years
• Total strokes documented: 52,500
• Within cancer survivors: 1,338 strokes
• Within noncancer patients: 51,182 strokes
Stroke risk reduction with ERC:
• Within cancer survivors: Adjusted Hazard Ratio (aHR) 0.67 (95% CI: 0.58–0.76)
• Within noncancer patients: aHR 0.76 (95% CI: 0.74–0.78)
The results of this Korean national study corroborate that earlier rhythm control is correlated with a significant decrease in the risk of ischemic stroke in cancer survivors with atrial fibrillation. These findings support a more vigorous and active role in rhythm management treatment for patients with a past history of cancer. Incorporating ERC into routine AF management in this subgroup may result in better stroke prevention and overall quality of life.
Reference:
Han S, Lee SR, Choi EK, Kim B, Han KD, Choi J, Lee KY, Ahn HJ, Kwon S, Oh S, Lip GYH. Early Rhythm Control of Atrial Fibrillation in Cancer Survivors: A Nationwide Population-Based Study. J Am Heart Assoc. 2025 Jun 23:e040908. doi: 10.1161/JAHA.125.040908. Epub ahead of print. PMID: 40551338.
