CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0041-1731907
Review Article

Bradyarrhythmias in Cardio-Oncology

Marta Fonseca
1  Division of Cardiology Cardiac-Oncology Service, Bart’s Heart Centre, St Bartholomew’s Hospital West Smithfield, London, United Kingdom
2  Hatter Cardiovascular Institute, Institute of Cardiovascular Science UCL, University College London Hospital, London, United Kingdom
,
3  UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Duc Do
3  UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Shouvik Haldar
4  Division of Cardiology Heart Rhythm Centre, The Royal Brompton and Harefield Hospitals, Guys & St Thomas’ NHS Foundation Trust, London, United Kingdom
5  National Heart and Lung Institute, Imperial College, London, United Kingdom
,
Shelby Kutty
6  The Helen B. Taussig Heart Center, The Johns Hopkins Hospital and Johns Hopkins University, Baltimore, Maryland, United States
,
Eric H. Yang
3  UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, California, United States
,
Arjun K. Ghosh
1  Division of Cardiology Cardiac-Oncology Service, Bart’s Heart Centre, St Bartholomew’s Hospital West Smithfield, London, United Kingdom
2  Hatter Cardiovascular Institute, Institute of Cardiovascular Science UCL, University College London Hospital, London, United Kingdom
,
Avirup Guha
7  Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio, United States
8  Division of Cardiology, Department of Medicine, Augusta University, Augusta, Georgia, United States
9  Division of Cardiology-Oncology Program, The Ohio State University, Columbus, Ohio, United States
› Author Affiliations
Funding None.

Abstract

The relationship between bradyarrhythmias and cancer therapies has not been well described but is increasingly recognized. There have been extensive advances in oncological pharmacotherapy, with several new classes of drugs available including targeted agents, immune checkpoint inhibitors and CAR T cell therapy. This increasing repertoire of available drugs has revolutionized overall prognosis and survival of cancer patients but the true extent of their cardiovascular toxicity is only beginning to be understood. Previous studies and published reviews have traditionally focused on conventional chemotherapies and in arrhythmias in general, particularly tachyarrhythmias. The number of patients with both cancer and cardiovascular problems is increasing globally and oncologists and cardiologists need to be adept at managing arrythmia based scenarios. Greater collaboration between the two specialties including studies with prospective data collection in Cardio-Oncology are much needed to fill in knowledge gaps in this arena. This case-based review summarizes current available evidence of cancer treatment-related bradyarrhythmia incidence (including its different subtypes), possible mechanisms and outcomes. Furthermore, we propose a stepwise surveillance and management protocol for patients with suspected bradyarrhythmia related to cancer treatment.

Joint senior authors.




Publication History

Publication Date:
15 October 2021 (online)

© 2021. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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