LAUSR

To the Editor, Primary cardiac tumors are rare and their contemporary characteristics remain unclear. Heaton et al. summarized characteristics of over 10,000 patients with a primary diagnosis of primary cardiac tumors. They found that surgical intervention was more commonly practiced and was associated with better in‐hospital mortality compared with medical therapy. Several concerns have been raised. In real‐world practice, the early diagnosis of primary cardiac tumors is sometimes challenging. It would be practical to summarize the sign and symptoms before the diagnosis of benign/malignant tumors, respectively. In patients with a medical group, probably not all patients received chemotherapy. It might be informative to stratify the medical group into those with and without chemotherapy to investigate the outcomes of chemotherapy. In some cases, we hesitate total tumor resection given the risk of dissemination of tumor cells, failure of anatomical repair, and worsening heart failure. It would be practical for readers to show data of postsurgical complications. The authors reported that the existence of atrial fibrillation was associated with undergoing the surgery. Atrial fibrillation is in general associated with high age and comorbidity such as heart failure, hypertension, and diabetes mellitus, all of which would be surgical high‐risk factors. Could the authors explain the mechanism why those with atrial fibrillation tended to receive surgery? CONFLICT OF INTEREST The author declares that there are no conflict of interest.