Electrophysiology Translational Considerations in Cardio-Oncology: QT and Beyond

J Cardiovasc Transl Res. 2020 Jun;13(3):390-401. doi: 10.1007/s12265-019-09924-y. Epub 2019 Oct 31.

Abstract

With improved screening and the advent of many novel therapeutics, patients with cancer are living longer and often surviving their disease. Cardiovascular complications have significant impact on both short- and long-term morbidity and mortality in these patients. While a great deal of attention has been paid to cardiomyopathy and heart failure, many other cardiotoxicities can occur, often at higher rates. Arrhythmias are a particularly common cardiovascular complication of cancer therapeutics and can range from benign to life threatening. Moreover, management of these rhythm disturbances can be challenging in cancer patients for various reasons including drug interactions, as well as underlying hematologic and metabolic disturbances. In this review, we describe the most common therapeutics associated with arrhythmias in cancer patients and provide a discussion about the potential basic and translational mechanisms leading to the development of the various rhythm disturbances which may help to guide prevention and treatment decisions. Clinicaltrials.gov Identifier: NCT02928497.

Keywords: Arrhythmias; Atrial fibrillation; Cardio-oncology; Cardiotoxicity; QT prolongation.

Publication types

  • Review

MeSH terms

  • Action Potentials / drug effects
  • Animals
  • Antineoplastic Agents / adverse effects*
  • Arrhythmias, Cardiac / chemically induced*
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / therapy
  • Cancer Survivors*
  • Cardiac Electrophysiology*
  • Cardiotoxicity
  • Heart Conduction System / drug effects*
  • Heart Conduction System / physiopathology
  • Heart Rate / drug effects
  • Humans
  • Medical Oncology*
  • Neoplasms / drug therapy*
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Translational Medical Research*

Substances

  • Antineoplastic Agents

Associated data

  • ClinicalTrials.gov/NCT02928497