Arrhythmias and Other Electrophysiology Issues in Cancer Patients Receiving Chemotherapy or Radiation.
Enhanced understanding of cancer biology has significantly increased treatment options and dramatically improved outcomes for patients with malignancies. Despite these advances, many therapies have cardiovascular toxicities which can affect morbidity and mortality independent of the oncologic prognosis. Arrhythmias and other electrophysiology issues are increasingly identified as common complications of cancer therapy. Atrial fibrillation and other supraventricular arrhythmias are frequently observed in cancer patients receiving chemotherapy, often due to their effects on intracellular signaling pathways. Similarly, many oncologic pharmaceuticals can lead to QT prolongation and possible ventricular arrhythmias including torsades do pointes. Management of these arrhythmias can be challenging as typical treatment strategies may not be feasible in cancer patients. Finally, a proportion of individuals with cancer will present with an implantable cardiac device (pacemaker or defibrillator) which poses unique challenges should radiation be necessary in the region of the device. Given the frequency of electrophysiology complications in cancer patients, it is essential for cardio-oncologists to possess knowledge of these issues in order to provide optimal care.
Division of Cardiovascular Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL, 33606, USA.|Cardio-Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
Federico
F
Viganego
Division of Cardiovascular Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL, 33606, USA.
Robin
R
Singh
Division of Cardiovascular Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL, 33606, USA. mfradley@health.usf.edu.|Cardio-Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA. mfradley@health.usf.edu.
Michael G
MG
Fradley
D000970:Antineoplastic Agents / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D054715:Cardiotoxins / Q000009:adverse effects*; D004562:Electrocardiography; D004594:Electrophysiology; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects*
D000970:Antineoplastic Agents; D054715:Cardiotoxins
Arrhythmias; Atrial Fibrillation; Cardio-oncology; Cardiotoxicity; Chemotherapy; Radiation