Patients who undergo lung cancer surgery face up to four times the risk of developing atrial fibrillation within the first year after surgery compared with the general population, but the increase gradually slows thereafter, according to a study.
Samsung Medical Center said on the 10th that the findings emerged from a comparative analysis of 34,519 lung cancer surgery patients and 103,557 people in a general population control group, conducted by a research team of thoracic and esophageal surgery professors Cho Jong-ho and Yun Dong-wook and family medicine professor Shin Dong-wook using National Health Insurance Service big data.
Atrial fibrillation is a condition in which the atria, the upper chambers of the heart, do not beat regularly but instead quiver irregularly. It is a type of arrhythmia that occurs relatively commonly after lung cancer surgery, and inflammatory responses immediately after surgery, changes in the autonomic nervous system, and hemodynamic changes following lung resection are known to have an effect. The problem is that such atrial fibrillation is associated with an increased risk of stroke, heart failure, and death. When atrial fibrillation occurs, blood flow within the heart stagnates, making it easy for blood clots to form. If such a clot breaks off and leaves the heart, it can block blood vessels in the brain or heart. It is also considered one of the important cardiovascular diseases in terms of the long-term health management of cancer survivors.
When the research team tracked patients who underwent lung cancer surgery from 2010 to 2017, the risk of atrial fibrillation among all lung cancer surgery patients was 1.61 times higher than the general population. In particular, within the first year after surgery, the risk surged to 4.06 times, reaching its peak.
This risk showed a clear pattern of decline over time. Among lung cancer patients who received surgical treatment only, the risk of developing atrial fibrillation within one year after surgery was 3.26 times higher than the general population. However, it gradually declined thereafter, and from three years after surgery, there was no statistically significant difference from the general population. However, in some patient groups who additionally underwent linked treatment after lung cancer surgery, the atrial fibrillation risk was found to tend to remain relatively high for a slightly longer period.
This means that the risk of atrial fibrillation after lung cancer surgery does not persist equally in all patients, but can vary depending on the time elapsed after surgery and the treatment process. According to the National Cancer Information Center, the five-year relative survival rate of lung cancer patients in Korea rose significantly from 16.6% based on 2001-2005 to 42.5% in 2019-2023. The five-year relative survival rate of lung cancer patients treated at Samsung Medical Center reaches 65.7%. As long-term survivors increase due to improvements in lung cancer treatment outcomes, the importance of managing cardiovascular complications that occur after cancer treatment is also growing. The research team concluded that, rather than applying long-term cardiovascular surveillance of the same intensity to all lung cancer surgery patients, a follow-up strategy based on the risk level of individual patients is needed.
Professor Yun Dong-wook explained, "We confirmed with nationwide data that while the risk of atrial fibrillation is highest immediately after lung cancer surgery, the long-term risk pattern changes depending on factors such as the passage of time and the treatment process."
Professor Cho Jong-ho, the lead researcher, said, "As the treatment outcomes of lung cancer patients continue to improve, the importance of cardiovascular health management after cancer treatment is also growing," adding, "This study presented evidence that a customized surveillance strategy based on risk level is needed, rather than applying the same follow-up to all patients."
The findings were published in a recent issue of The Annals of Thoracic Surgery, the official journal of the American Association for Thoracic Surgery.
