4.3 Review

Atrial Fibrillation and Cancer Patients: Mechanisms and Management

Journal

CURRENT CARDIOLOGY REPORTS
Volume 24, Issue 10, Pages 1517-1527

Publisher

SPRINGER
DOI: 10.1007/s11886-022-01769-3

Keywords

Atrial fibrillation; Cancer; Cardio-oncology; Cardiotoxicity; Oral anticoagulants; Arrhythmias

Funding

  1. NIH [R01HL151659]

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The incidence of atrial fibrillation is increasing among cancer patients and survivors, potentially due to shared risk factors and biology between the two conditions. Cancer treatment may also contribute to the development of arrhythmia. Further research is needed to understand this relationship and establish prevention and treatment strategies specific to this population.
Purpose of Review Cancer-related mortality has significantly declined over the past several decades as a result of improved screening, diagnostics, and therapeutics. Although cancer patients and survivors are living longer, there is increased risk of both short-term and long-term cardiovascular complications, including arrhythmia. In this review, we highlight the current evidence detailing the connections between atrial fibrillation and cancer, provide insight into the mechanisms driving this relationship, and share practical considerations for the management of atrial fibrillation in cancer patients and cancer survivors. Recent Findings Atrial fibrillation is an increasingly recognized condition among cancer patients, with epidemiological data showing increased incidence and worse outcomes in patients with cancer. Studies also describe a bidirectional relationship between cancer and atrial fibrillation, attributable in part to shared risk factors but also potentially due to shared biology. Cancer treatment-associated arrhythmia is an active area of investigation, with ongoing research to identify the mechanisms and pathophysiology behind this phenomenon. Furthermore, management of atrial fibrillation in patients with cancer presents unique challenges, particularly in management of anti-coagulation. Cancer patients have increased risk of developing atrial fibrillation due to the shared risk factors and biology of the two conditions. Moreover, various cancer therapeutics are known to be arrhythmogenic; however, mechanisms remain unclear. Further research is needed to better understand the pathophysiology of atrial fibrillation in cancer patient in order to establish prevention and treatment strategies specific to this population.

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