The relationship between chemotherapy and arrhythmias has not been well established. We reviewed the existing literature to better understand this connection. We reviewed published reports on chemotherapy-induced arrhythmias in English using the PubMed/Medline and OVID databases from 1950 onwards as well as lateral references. Arrhythmias were reported as a side effect of many chemotherapeutic drugs. Anthracyclines are associated with atrial fibrillation (AF) at a rate of 2-10%, but rarely with ventricular tachycardia (VT)/fibrillation. Taxol and other antimicrotubular drugs are safe in terms of pro-arrhythmic side effects and do not cause any consistent rhythm abnormalities. Arrhythmias induced by 5-fluorouracil, including VT, are mostly ischaemic in origin and usually occur in the context of coronary spasm produced by this drug. Cisplatin-particularly with intrapericardial use-is associated with a very high rate of AF (12-32%). Melphalan is associated with AF in 7-12% of cases, but it does not appear to cause VT. Interleukin-2 is linked to frequent arrhythmia, mostly AF. We summarized the available data on chemotherapy-induced arrhythmia, particularly AF and VT. Studies with prospective data collection and thorough analyses are needed to establish a causal relationship between certain anticancer drugs and arrhythmia.

/pdf/introducing-a-new-entity-chemotherapy-induced-arrhythmia-2c0cbaroht.pdf

Introducing a new entity: chemotherapy-induced arrhythmia.

With the development of newer drugs and improvements in established treatment protocols, prognosis for many types of cancer has improved dramatically. Some cancers that were historically associated with high fatality rates now have high cure rates or successful palliation, turning the malignancy into a chronic disease. Given this improved prognosis, more patients will face the adverse effects of cancer treatment. Cancer therapy can result in cardiac toxicity, such as cardiomyopathy. Cardiotoxicity with chemotherapeutic agents in the form of cardiomyopathy was first described in 1966 in patients receiving anthracyclines.1 However, cancer treatment–induced arrhythmia (CTIA) has not attracted specific attention until recently.2

CTIA is a complex entity with multiple factors involved in its pathogenesis. It can be divided into primary CTIA (caused by a drug disrupting specific molecular pathways critical for the development of a specific arrhythmia) and secondary CTIA (caused by damage to the endocardium/myocardium/pericardium through ischemia, inflammation, or radiation therapy (RT), with arrhythmia as a secondary phenomenon). Secondary CTIA is much more common. The distinction between primary and secondary CTIA is not well defined, with many contributing and confounding factors, and the exact mechanisms for many drugs are still to be elucidated (Figure).



Figure. 
Mechanisms of arrhythmias in cancer patients. AC indicates anthracyclines; ATO, arsenic trioxide; HA, histamine; hERG, human Ether-a-go-go -Related Gene; PI3K, phosphotidyl inositol 3–kinase; PKI, protein kinase inhibitors; SB, sinus bradycardia; and 5-FU, 5-fluorouracil. Heart image reprinted with permission from Marieb and Hoehn.3 Copyright © 2013, Pearson Education, Inc.



The incidence of CTIA with many chemotherapeutic agents is yet to be firmly established as most chemotherapy trials have not had adequate numbers of patients enrolled to study this problem. In addition, most cancer treatment trials have excluded patients with preexisting cardiac disease, which is the most vulnerable population for CTIA. The National Cancer Institute …

Cancer Treatment-Induced Arrhythmias: Focus on Chemotherapy and Targeted Therapies.

Anticancer drug-induced cardiac rhythm disorders: Current knowledge and basic underlying mechanisms

Background: Due to demographic changes, the number of elderly people with cancer will increase in the next decades. In the past, elderly patients with cancer were often excluded from clinical trials. Chronological age has been considered a risk factor for increased toxicity and reduced tolerance to chemotherapy. Methods: We present a review on toxicity of chemotherapy and factors associated with toxicity in elderly patients with cancer, and we discuss chemotherapeutic agents and treatment options in treating this patient population. Results: Age is a risk factor for increased toxicity to chemotherapy and decreased tolerance. However, few trials have been reported with adjustment for age-associated changes such as impairment of functional status and increased comorbidity, which also show an independent association with increased toxicity. Published data may include several biases, such as referral and publication bias. Conclusions: Decision making in elderly cancer patients should be based on the results of a geriatric assessment. Patients with few or no limitations should be treated as younger patients are treated. Data with a high level of evidence are unavailable for patients showing moderate or severe limitations in a geriatric assessment. The factors associated with increased toxicity, and the current recommendations for different chemotherapeutic agents and treatment situations are reviewed.

https://journals.sagepub.com/doi/pdf/10.1177/107327480701400106

Tolerance to chemotherapy in elderly patients with cancer.

Introduction: Atrial fibrillation (AF) is the most common arrhythmia and an important cause of hospitalization, morbidity, and mortality. A myriad of drugs can induce AF. However, drug-induced AF (DIAF) receives little attention. Thus, this review is an attempt to attract the attention on this adverse effect. Areas covered: Published reports of drug-induced AF (DIAF) are reviewed in this paper, from January 1974 to December 2011, using the PubMed/Medline database and lateral references. Expert opinion: In most cases, DIAF is paroxysmal and terminates spontaneously, but sometimes AF persists and it is necessary to perform a cardioversion to restore sinus rhythm and avoid progression to persistent AF. Because of the short duration of DIAF, in addition to physicians/patients not being knowledgeable about this side effect, the real incidence and clinical consequences of DIAF are presently unknown. DIAF is an increasing problem, as some widely prescribed drugs can present this adverse effect. The risk is expec...

/pdf/drug-induced-atrial-fibrillation-523ai0tn2f.pdf

Drug-induced atrial fibrillation.

High-dose therapy (HDT) for non-Hodgkins lymphoma (NHL) and multiple myeloma (MM) is considered a feasible option for patients aged ⩾60 years. This study compared the outcomes for all patients aged ⩾60 years treated with HDT at the center to a matched cohort group aged <60 years. Results for patients who were ⩾60 years at HDT between 1997 – 2002 were retrospectively analysed to assess efficacy and safety. Event-free (EFS) and overall survival (OS) rates were compared with a cohort group, matched by disease type, chemotherapy sensitivity, year of treatment and conditioning regimen. Patients with NHL were also matched by International Prognostic Index score. Forty patients aged ⩾60 years were identified. Median age was 65 (range 60 – 76) with 22 MM and 18 NHL; 50% had 1 or more co-morbidity; 35% had cardiovascular co-morbidity vs. 18% of controls (p = 0.075). Response rates (RR) following HDT for MM were: 4 (18%) complete responses (CR) and 18 (82%) partial responses (PR), giving an overall response rate (O...

Cardiovascular toxicity is increased, but manageable, during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for patients aged 60 years and older.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

P. Joyce

Author Tools

Chat about Author

Papers

Cardiovascular toxicity is increased, but manageable, during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for patients aged 60 years and older.