Radiation Therapy Tied to 8.5% Atrial Fibrillation Prevalence in Cancer Patients, Meta-Analysis Finds

Patients with cancer who receive radiation therapy show a pooled prevalence of atrial fibrillation of 8.5%, according to a systematic review and meta-analysis published in the journal Cardio-Oncology. The analysis, prospectively registered on PROSPERO (CRD420261382387), combined data from 23 studies covering 97,213 patients and calculated prevalence estimates with a random-effects model. The pooled estimate came with a 95% confidence interval of 5.6% to 12.0%, a wide range that reflects substantial variation across the included studies.

That variation was itself a central finding. Between-study heterogeneity was severe, with an I² statistic of 99.1%, meaning almost all of the variability in reported prevalence was attributable to differences between studies rather than to chance within them. Reported prevalence also differed by cancer type: estimates were highest in esophageal cancer at 15.0%, followed by lung cancer at 7.4% and breast cancer at 3.7%. The authors note that the prevalence of atrial fibrillation in patients with cancer receiving radiation therapy has remained poorly characterized, which motivated the stratified analysis and the exploration of sources of variability.

To probe what drives the differences, the researchers performed subgroup analyses by cancer type, region, and study design, and then used meta-regression to test associations between atrial fibrillation prevalence and several candidate factors: chemotherapy exposure, age, baseline coronary artery disease prevalence, and cancer type. Chemotherapy exposure and individual cancer-type comparisons were not significant in this model.

The regression model explained 54.2% of the between-study heterogeneity, but substantial residual heterogeneity persisted even after adjustment, with a residual I² of 91.49%. In other words, known and measured factors accounted for roughly half of the variability, leaving much of it unexplained. A leave-one-out sensitivity analysis, which recalculates the pooled estimate while excluding each study in turn, showed stable results ranging from 7.8% to 9.1%, indicating that no single study dominated the overall estimate.

The methods behind these numbers were systematic. The literature search covered PubMed, Scopus, the Cochrane Library, and Google Scholar from database inception to April 2026, identifying studies that reported atrial fibrillation prevalence among patients receiving radiation therapy. Heterogeneity was assessed with the I² statistic and Cochran’s Q test. The authors conclude that further prospective studies are required to clarify the nature and determinants of the observed prevalence, and the pooled figure should be read as a synthesis of heterogeneous observational estimates rather than a precise population rate. Because the article was published as an accepted, peer-reviewed manuscript shared early with a permanent DOI, it remains subject to further edits before the final version of record replaces it.

Subject of Research: Pooled prevalence of atrial fibrillation in cancer patients treated with radiation therapy

Article Title: Prevalence of atrial fibrillation in cancer patients treated with radiation therapy: a systematic review and meta-analysis

Article References: Mohammed, A. S., Patel, N. J., Guntuku, S., Lingamsetty, S., Salian, R. B., Sai Krishna Medarametla, R. V., Takagi, M. A., Yasmeen, U., Desai, R., Baqal, O., & Narayanasamy, H. (2026). Prevalence of atrial fibrillation in cancer patients treated with radiation therapy: a systematic review and meta-analysis. Cardio-Oncology. https://doi.org/10.1186/s40959-026-00597-6

Image Credits: AI Generated

DOI: 10.1186/s40959-026-00597-6

Keywords: atrial fibrillation, radiation therapy, cancer, meta-analysis, cardio-oncology, prevalence, coronary artery disease, heterogeneity, esophageal cancer, PROSPERO, atrial, fibrillation