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Atrial Fibrillation and Cancer Patients: Mechanisms and Management

  • Cardio-Oncology (LA Baldassarre, Section Editor)
  • Published:
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Abstract

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.

Summary

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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Funding

MGF is supported by NIH R01HL151659.

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  1. Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    David L. Madnick & Michael G. Fradley

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MGF reports the following financial disclosures: research grants—Medtronic and AstraZeneca; consulting—Abbott Inc., Zoll, AstraZeneca, and Takeda. DLM has no disclosures to report.

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Madnick, D.L., Fradley, M.G. Atrial Fibrillation and Cancer Patients: Mechanisms and Management. Curr Cardiol Rep 24, 1517–1527 (2022). https://doi.org/10.1007/s11886-022-01769-3

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