title: Cancer chemotherapy and cardiac arrhythmias: a review.
abstract: Cardiovascular toxicity is a potential complication of cancer chemotherapy (CC) that increases the morbidity and mortality of cancer patients. Cardiac arrhythmias have been reported as an adverse effect of many chemotherapeutic drugs, including novel targeted therapies. The relationship between chemotherapy and arrhythmias has not been well-established and the proarrhythmogenic mechanisms remain uncertain as they can be the result of a direct electrophysiological effect or of changes in cardiac structure and function, including myocardial ischaemia and heart failure, which create an arrhythmogenic substrate. In this review we summarise available evidence of proarrhythmia induced by CC, discuss the possible mechanisms involved in this adverse effect and emphasise the importance of cardiac monitoring for the early diagnosis, intervention and surveillance of those patients more susceptible to develop proarrhythmia in an attempt to reduce the morbidity and mortality. Oncologists should be fully aware of proarrhythmia and the close collaboration between cardiologists and oncologists would result in a better cardiovascular assessment, risk stratification, cardiac monitoring and treatment during CC and during the follow-up. The final objective is to understand the mechanisms of proarrhythmia and evaluate its real incidence and clinical relevance so as to select the safest and most effective treatment for cancer patients.
authors.affiliation: Department of Pharmacology, School of Medicine, University Complutense, 28040, Madrid, Spain, jtamargo@med.ucm.es.
authors.forename: Juan
authors.initials: J
authors.lastname: Tamargo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Caballero
authors.forename: Eva
authors.initials: E
authors.lastname: Delpón
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D066126:Cardiotoxicity; D004562:Electrocardiography; D006329:Heart Conduction System / Q000187:drug effects; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents