Kinase Inhibitors and Atrial Fibrillation Mechanisms of Action and Clinical Implications

Recent advances have significantly expanded the options of available therapeutics for cancer treatment, including novel targeted cancer therapies. Within this broad category of targeted therapies is the class of kinase inhibitors (KIs), which target kinases that have undergone aberrant activation in cancerous cells. Although KIs have shown a benefit in treating various forms of malignancy, they have also been shown to cause a wide array of cardiovascular toxicities, with cardiac arrhythmias, in particular atrial fibrillation (AF), being 1 of the predominant side effects. The occurrence of AF in patients undergoing cancer treatment can complicate the treatment approach and poses unique clinical challenges. The association of KIs and AF has led to new research aimed at trying to elucidate the underlying mechanisms. Furthermore, there are unique considerations to treating KI-induced AF because of the anticoagulant properties of some KIs as well as drug-drug interactions with KIs and some cardiovascular medications. Here, we review the current literature pertaining to KI-induced AF. (J Am Coll Cardiol EP 2023;9:591-602) (c) 2023 by the American College of Cardiology Foundation.

Automated summary

Recent advances in cancer treatment have provided more therapeutic options, including targeted therapies such as kinase inhibitors (KIs). However, KIs have been shown to cause various cardiovascular toxicities, with atrial fibrillation (AF) being one of the major side effects. Understanding the underlying mechanisms and managing AF in cancer patients receiving KI treatment present unique challenges.