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Atrial Fibrillation in Cancer

  • Dimitrios Farmakis
  • George Papingiotis
  • Gerasimos Filippatos
  • Annamaria Bonelli
  • Nicola Maurea
Chapter
Part of the Current Clinical Pathology book series (CCPATH)

Abstract

Advances in cancer therapy have led to a significant improvement of survival in most types of malignancies over the past few decades. As a result, there is a growing population of cancer survivors, expected to reach 18 million people in 2030 in the USA and a similar number in Europe. Interestingly, cancer survivor studies have shown that although about half of these patients eventually die of cancer, one-third of them actually die of cardiovascular disease.

Cardiovascular complications in patients with cancer result from the interaction of three main factors: cancer therapy that may confer cardiac or vascular toxicity, cancer itself that may affect the heart directly and mainly indirectly, and the underlying cardiovascular status of patients in terms of coexistent heart disease or cardiovascular risk factors. The cardiovascular spectrum of cancer patients is quite wide, comprising practically every form of cardiac or vascular disease. Arrhythmias represent a significant part of this spectrum, and atrial fibrillation (AF) is one of the main arrhythmias occurring in cancer patients.

Several studies have documented the relationship between cancer and AF. In terms of epidemiology, AF in cancer could be divided into two forms according to whether it occurs during the perioperative period of cancer surgery (perioperative AF) or not.

Keywords

Atrial fibrillation Arrhythmias Cancer Cardiotoxicity Anticancer drugs NOAC Anticoagulation Target therapy 

References

  1. 1.
    De Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, et al. Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomark Prev. 2013;22:561–70.CrossRefGoogle Scholar
  2. 2.
    Ning Y, Shen Q, Herrick K, Mikkelsen R, Anscher M, Houlihan R, et al. Abstract LB-339: cause of death in cancer survivors. Cancer Res. 2012;72(8):LB-339.Google Scholar
  3. 3.
    Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13:R64.CrossRefGoogle Scholar
  4. 4.
    Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit ME Jr, Ruccione K, et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol. 2001;19:3163–72.CrossRefGoogle Scholar
  5. 5.
    Zamorano JL, Lancellotti P, Rodriguez Munoz D, Aboyans V, Asteggiano R, Galderisi M, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur J Heart Fail. 2017;19:9–42.CrossRefGoogle Scholar
  6. 6.
    Guzzetti S, Costantino G, Sada S, Fundaro C. Colorectal cancer and atrial fibrillation: a case-control study. Am J Med. 2002;112:587–8.CrossRefGoogle Scholar
  7. 7.
    Guzzetti S, Costantino G, Vernocchi A, Sada S, Fundaro C. First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation. Intern Emerg Med. 2008;3:227–31.CrossRefGoogle Scholar
  8. 8.
    Wilkinson GS, Baillargeon J, Kuo YF, Freeman JL, Goodwin JS. Atrial fibrillation and stroke associated with intravenous bisphosphonate therapy in older patients with cancer. J Clin Oncol. 2010;28:4898–905.CrossRefGoogle Scholar
  9. 9.
    Erichsen R, Christiansen CF, Froslev T, Jacobsen J, Sorensen HT. Intravenous bisphosphonate therapy and atrial fibrillation/flutter risk in cancer patients: a nationwide cohort study. Br J Cancer. 2011;105:881–3.CrossRefGoogle Scholar
  10. 10.
    Hu YF, Liu CJ, Chang PM, Tsao HM, Lin YJ, Chang SL, et al. Incident thromboembolism and heart failure associated with new-onset atrial fibrillation in cancer patients. Int J Cardiol. 2013;165:355–7.CrossRefGoogle Scholar
  11. 11.
    Abonowara A, Quraishi A, Sapp JL, Alqambar MH, Saric A, O’Connell CM, et al. Prevalence of atrial fibrillation in patients taking TSH suppression therapy for management of thyroid cancer. Clin Invest Med. 2012;35:E152–6.CrossRefGoogle Scholar
  12. 12.
    O’Neal WT, Lakoski SG, Qureshi W, Judd SE, Howard G, Howard VJ, et al. Relation between cancer and atrial fibrillation (from the REasons for Geographic and Racial Differences in Stroke Study). Am J Cardiol. 2015;115:1090–4.CrossRefGoogle Scholar
  13. 13.
    Kim CH, Al-Kindi SG, Oliveira GH. Atrial fibrillation and cancer-validation in the real world. JAMA Cardiol. 2017;2:343–4.CrossRefGoogle Scholar
  14. 14.
    Cardinale D, Martinoni A, Cipolla CM, Civelli M, Lamantia G, Fiorentini C, et al. Atrial fibrillation after operation for lung cancer: clinical and prognostic significance. Ann Thorac Surg. 1999;68:1827–31.CrossRefGoogle Scholar
  15. 15.
    Walsh SR, Gladwish KM, Ward NJ, Justin TA, Keeling NJ. Atrial fibrillation and survival in colorectal cancer. World J Surg Oncol. 2004;2:40.CrossRefGoogle Scholar
  16. 16.
    Siu CW, Tung HM, Chu KW, Jim MH, Lau CP, Tse HF. Prevalence and predictors of new-onset atrial fibrillation after elective surgery for colorectal cancer. Pacing Clin Electrophysiol. 2005;28(Suppl 1):S120–3.CrossRefGoogle Scholar
  17. 17.
    Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130:438–44.CrossRefGoogle Scholar
  18. 18.
    Cardinale D, Colombo A, Sandri MT, Lamantia G, Colombo N, Civelli M, et al. Increased perioperative N-terminal pro-B-type natriuretic peptide levels predict atrial fibrillation after thoracic surgery for lung cancer. Circulation. 2007;115:1339–44.CrossRefGoogle Scholar
  19. 19.
    Salvatici M, Cardinale D, Spaggiari L, Veglia F, Tedesco CC, Solli P, et al. Atrial fibrillation after thoracic surgery for lung cancer: use of a single cut-off value of N-terminal pro-B type natriuretic peptide to identify patients at risk. Biomarkers. 2010;15:259–65.CrossRefGoogle Scholar
  20. 20.
    Onaitis M, D’Amico T, Zhao Y, O’Brien S, Harpole D. Risk factors for atrial fibrillation after lung cancer surgery: analysis of the Society of Thoracic Surgeons general thoracic surgery database. Ann Thorac Surg. 2010;90:368–74.CrossRefGoogle Scholar
  21. 21.
    Nojiri T, Maeda H, Takeuchi Y, Funakoshi Y, Maekura R, Yamamoto K, et al. Predictive value of preoperative tissue Doppler echocardiographic analysis for postoperative atrial fibrillation after pulmonary resection for lung cancer. J Thorac Cardiovasc Surg. 2010;140:764–8.CrossRefGoogle Scholar
  22. 22.
    Nojiri T, Maeda H, Takeuchi Y, Funakoshi Y, Kimura T, Maekura R, et al. Predictive value of B-type natriuretic peptide for postoperative atrial fibrillation following pulmonary resection for lung cancer. Eur J Cardiothorac Surg. 2010;37:787–91.CrossRefGoogle Scholar
  23. 23.
    Nojiri T, Yamamoto K, Maeda H, Takeuchi Y, Funakoshi Y, Maekura R, et al. Efficacy of low-dose landiolol, an ultrashort-acting beta-blocker, on postoperative atrial fibrillation in patients undergoing pulmonary resection for lung cancer. Gen Thorac Cardiovasc Surg. 2011;59:799–805.CrossRefGoogle Scholar
  24. 24.
    Imperatori A, Mariscalco G, Riganti G, Rotolo N, Conti V, Dominioni L. Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study. J Cardiothorac Surg. 2012;7:4.CrossRefGoogle Scholar
  25. 25.
    Ciszewski P, Tyczka J, Nadolski J, Roszak M, Dyszkiewicz W. Lower preoperative fluctuation of heart rate variability is an independent risk factor for postoperative atrial fibrillation in patients undergoing major pulmonary resection. Interact Cardiovasc Thorac Surg. 2013;17:680–6.CrossRefGoogle Scholar
  26. 26.
    Ojima T, Iwahashi M, Nakamori M, Nakamura M, Katsuda M, Iida T, et al. Atrial fibrillation after esophageal cancer surgery: an analysis of 207 consecutive patients. Surg Today. 2014;44:839–47.CrossRefGoogle Scholar
  27. 27.
    Chin JH, Moon YJ, Jo JY, Han YA, Kim HR, Lee EH, et al. Association between postoperatively developed atrial fibrillation and long-term mortality after esophagectomy in esophageal cancer patients: an observational study. PLoS One. 2016;11:e0154931.CrossRefGoogle Scholar
  28. 28.
    Farmakis D, Parissis J, Filippatos G. Insights into onco-cardiology: atrial fibrillation in cancer. J Am Coll Cardiol. 2014;63:945–53.CrossRefGoogle Scholar
  29. 29.
    Erichsen R, Christiansen CF, Mehnert F, Weiss NS, Baron JA, Sorensen HT. Colorectal cancer and risk of atrial fibrillation and flutter: a population-based case-control study. Intern Emerg Med. 2012;7:431–8.CrossRefGoogle Scholar
  30. 30.
    Ostenfeld EB, Erichsen R, Pedersen L, Farkas DK, Weiss NS, Sorensen HT. Atrial fibrillation as a marker of occult cancer. PLoS One. 2014;9:e102861.CrossRefGoogle Scholar
  31. 31.
    Conen D, Wong JA, Sandhu RK, Cook NR, Lee IM, Buring JE, et al. Risk of malignant cancer among women with new-onset atrial fibrillation. JAMA Cardiol. 2016;1:389–96.CrossRefGoogle Scholar
  32. 32.
    Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace. 2016;18:1609–78.CrossRefGoogle Scholar
  33. 33.
    Denas G, Pengo V, Joppi R, Prandoni P. Cancer as a risk factor for stroke in atrial fibrillation patients receiving long-term oral anticoagulant therapy. Thromb Res. 2015;136:488.CrossRefGoogle Scholar
  34. 34.
    Lardaro T, Self WH, Barrett TW. Thirty-day mortality in ED patients with new onset atrial fibrillation and actively treated cancer. Am J Emerg Med. 2015;33:1483–8.CrossRefGoogle Scholar
  35. 35.
    Rahman F, Ko D, Benjamin EJ. Association of atrial fibrillation and cancer. JAMA Cardiol. 2016;1:384–6.CrossRefGoogle Scholar
  36. 36.
    Bickford CL, Agarwal R, Urbauer DL, Durand JB, Lenihan DJ. Efficacy and safety of ibutilide for chemical cardioversion of atrial fibrillation and atrial flutter in cancer patients. Am J Med Sci. 2014;347:277–81.CrossRefGoogle Scholar
  37. 37.
    Riber LP, Christensen TD, Jensen HK, Hoejsgaard A, Pilegaard HK. Amiodarone significantly decreases atrial fibrillation in patients undergoing surgery for lung cancer. Ann Thorac Surg. 2012;94:339–44. discussion 45–6CrossRefGoogle Scholar
  38. 38.
    Cardinale D, Sandri MT, Colombo A, Salvatici M, Tedeschi I, Bacchiani G, et al. Prevention of atrial fibrillation in high-risk patients undergoing lung cancer surgery: the PRESAGE Trial. Ann Surg. 2016;264:244–51.CrossRefGoogle Scholar
  39. 39.
    Niers TM, Klerk CP, DiNisio M, Van Noorden CJ, Buller HR, Reitsma PH, et al. Mechanisms of heparin induced anti-cancer activity in experimental cancer models. Crit Rev Oncol Hematol. 2007;61:195–207.CrossRefGoogle Scholar
  40. 40.
    Klerk CP, Smorenburg SM, Otten HM, Lensing AW, Prins MH, Piovella F, et al. The effect of low molecular weight heparin on survival in patients with advanced malignancy. J Clin Oncol. 2005;23:2130–5.CrossRefGoogle Scholar
  41. 41.
    Lee AY, Rickles FR, Julian JA, Gent M, Baker RI, Bowden C, et al. Randomized comparison of low molecular weight heparin and coumarin derivatives on the survival of patients with cancer and venous thromboembolism. J Clin Oncol. 2005;23:2123–9.CrossRefGoogle Scholar
  42. 42.
    Moreno-Arribas J, Bertomeu-Gonzalez V, Anguita-Sanchez M, Cequier A, Muniz J, Castillo J, et al. Choice of new oral anticoagulant agents versus vitamin k antagonists in atrial fibrillation: FANTASIIA Study. J Cardiovasc Pharmacol Ther. 2016;21:150–6.CrossRefGoogle Scholar
  43. 43.
    Pangilinan JM, Pangilinan PH Jr, Worden FP. Use of warfarin in the patient with cancer. J Support Oncol. 2007;5:131–6.PubMedGoogle Scholar
  44. 44.
    Laube ES, Yu A, Gupta D, Miao Y, Samedy P, Wills J, et al. Rivaroxaban for stroke prevention in patients with nonvalvular atrial fibrillation and active cancer. Am J Cardiol. 2017;120:213–7.CrossRefGoogle Scholar
  45. 45.
    Melloni C, Dunning A, Granger CB, Thomas L, Khouri MG, Garcia DA, et al. Efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation and a history of cancer: insights from the ARISTOTLE Trial. Am J Med. 2017;130:1440–8e1.CrossRefGoogle Scholar
  46. 46.
    Fanola C, Ruff C, Murphy S, Jin J, Duggal A, Mercuri M, et al. Efficacy and safety of edoxaban in patients with atrial fibrillation and active malignancy: an analysis of ENGAGE AF – TIMI 48 randomized clinical trial. J Am Coll Cardiol. 2017;69:325.CrossRefGoogle Scholar
  47. 47.
    Short NJ, Connors JM. New oral anticoagulants and the cancer patient. Oncologist. 2014;19:82–93.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Dimitrios Farmakis
    • 1
  • George Papingiotis
    • 1
  • Gerasimos Filippatos
    • 1
  • Annamaria Bonelli
    • 2
  • Nicola Maurea
    • 2
  1. 1.Department of Cardiology, Cardio-Oncology Clinic, Heart Failure UnitAttikon University Hospital, National and Kapodistrian University of AthensAthensGreece
  2. 2.Division of CardiologyIstituto Nazionale Tumori - IRCCS - Fondazione G. PascaleNaplesItaly

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