Cardiac Arrhythmias in Oncological Patients - Epidemiology, Risk Factors, and Management within the Context of the New ESC 2022 Guidelines

Sep 24, 2026

Uploaded by McQueen

Update on cardiac arrhythmias in oncological patients framed by the 2022 European Society of Cardiology cardio-oncology guidelines. Reviews pro-arrhythmic and cardiotoxic effects of anticancer therapies and the arrhythmogenic role of cancer itself, covering atrial and ventricular arrhythmias, QT prolongation, and bradyarrhythmias. Synthesizes how epidemiology and risk factors overlap with cardiovascular disease risks while highlighting drug groups that elevate cardiotoxicity risk, emphasizing how to recognize and respond to toxicity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Introduction

Epidemiology

Atrial Fibrillation

QT Prolongation and Ventricular Arrhythmias

Management within the ESC 2022 Guidelines

Cardiac Arrhythmias in Oncological Patients—Epidemiology, Risk Factors, and Management within the Context of the New ESC 2022 Guidelines Michał Gawlik1 · Jakub Michal Zimodro1 · Aleksandra Gąsecka1 · Krzysztof J. Filipiak2 · Sebastian Szmit3,4 Accepted: 25 July 2023 / Published online: 17 August 2023 © The Author(s) 2023 Abstract Purpose of Review To provide an update on epidemiology, risk factors, and management of cardiac arrhythmias in oncological patients within the context of the new European Society of Cardiology 2022 guidelines on cardio-oncology. Recent Findings One of the side effects of different chemotherapeutics is their pro-arrhythmic activity. Both atrial and ventricular arrhythmias may be induced by cancer itself or by anticancer treatment. Recent studies report on the cardiotoxic activity of such promising therapies as BRAF and MEK inhibitors, or CAR-T therapy. Summary Risk factors of arrhythmias in oncological patients overlap with cardiovascular diseases risk factors, but there are some groups of anticancer drugs that increase the risk of cardiotoxicity. It is crucial to be aware of the risks associated with the oncological treatment and know how to act in case of cardiotoxicity. Keywords Arrhythmia · Cardio-oncology · Cardiotoxicity · Cardiovascular disease Introduction Cardiovascular diseases (CVD) and cancer are the two most common causes of death worldwide, and their prevalence constantly increases . In 2014, cancer accounted for 1,345,680 deaths in Europe, whereas in 2019 it was responsible for over 1,409,700 deaths [1] . On the other hand, CVD causes over 4,000,000 deaths in Europe per year, accounting for 45% of overall deaths [2] . In August 2022, the first-ever official guidelines of the European Society of Cardiology (ESC) on cardio-oncology werepresented. The new guidelines aim to standardize the * Aleksandra Gąsecka [aleksandra.gasecka@wum.edu.pl](aleksandra.gasecka@wum.edu.pl) 1 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland 2 Institute of Clinical Sciences, Maria Skłodowska-Curie Medical Academy in Warsaw, Warsaw, Poland 3 Department of Cardio-Oncology, Centre of Postgraduate Medical Education, Institute of Hematology and Transfusion Medicine, Warsaw, Poland 4 Clinic of Oncological Diagnostics and Cardio-Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland management and facilitate the care of oncological patients who are exposed to the cardiotoxic effects of anti-cancer treatment . Currently, there is a trend of increasing life expectancy and thus an increased number of elderly people in the population with a higher chance of developing cancer and CVD, such as arrhythmias . The most common arrhythmia observed in oncological patients, as it is in patients without diagnosed cancer, is atrial fibrillation (AF) . Other types, such as QT-prolongation and ventricular arrhythmias (VA) or bradyarrhythmias can also appear, but less frequently. In this manuscript, we discuss (i) the epidemiology of the most common arrhythmias resulting from the presence of cancer or anti-cancer treatment,(ii) risk factors for arrhythmia in oncological patients,(iii) the management of various types of arrhythmias in the light of the latest ESC guidelines. Epidemiology The prevalence of arrhythmias in oncological patients differs, depending on the cancer type, oncological treatment, patient’s characteristics, and risk factors. The epidemiology of different arrhythmias in cancer patients is presented below. Atrial Fibrillation The overall incidence of AF in general population varies from 1 to 2%, whereas among oncological patients, it reaches between 5% and 16%, depending on the risk factors and cancer type [3 , 4] . Korean Nationwide Population-Based Study showed that AF is strongly connected with the presence of hematological and intrathoracic cancers with HR = 2.69 for esophageal cancer and H

FAQs

What are the main sources of arrhythmias in oncological patients discussed in the review?

Arrhythmias may be induced by cancer itself or by anticancer treatment, with chemotherapeutics showing pro-arrhythmic activity and certain therapies demonstrating cardiotoxic effects.

How does atrial fibrillation incidence in cancer patients compare with the general population?

In the general population, atrial fibrillation incidence is about 1–2%, while among oncological patients it reaches roughly 5–16% depending on risk factors and cancer type.

Which factors increase the risk of ventricular arrhythmias in cancer patients?

The review highlights medicine-related QT prolongation risk plus non-medicine factors such as electrolyte abnormalities and inadequate dosing of renal or hepatic-cleared QT-prolonging drugs.

Sep 24, 2026

Uploaded by McQueen