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Arrhythmias in Cancer Patients

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Oncologic Critical Care

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Abstract

Cardiac dysrhythmias are common in cancer patients. Recognition and management of dysrhythmias requires an understanding of common etiologies seen in the cancer population. These may include cancer involvement of the myocardium or various cancer treatments including chemotherapy, radiation, and surgery. They can also be due to other underlying comorbidities such as preexisting cardiovascular disease, electrolyte derangements, or hormonal abnormalities.

Clinical recognition of dysrhythmias can be challenging as they can present incidentally in an asymptomatic patient. When symptomatic, patients may present with palpitations, dizziness, syncope, or cardiac arrest. The diagnosis is often made through rhythm interpretation on a 12-lead ECG, Holter monitor, or bedside cardiac monitor.

Acute management of cardiac rhythm disorders includes urgent patient stabilization and discontinuation of offending agents. Treatment for the arrhythmias and conduction abnormalities may require the use of antiarrhythmic medications, electrical cardioversion, pacemaker placement, and need for anticoagulation in high-risk patients. Cardiac interventions may often conflict with cancer treatment such as in the case of magnetic resonance imaging in patients with pacemakers and anticoagulation in patients with thrombocytopenia. Reconciliation of these complex decisions requires a multidisciplinary approach with understanding of both the cardiovascular and oncologic risks.

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References

  1. Akl EA, Barba M, Rohilla S, Terrenato I, Sperati F, Muti P, Schünemann HJ. Low-molecular-weight heparins are superior to vitamin K antagonists for the long term treatment of venous thromboembolism in patients with cancer: a cochrane systematic review. J Exp Clin Cancer Res. 2008;27:21. https://doi.org/10.1186/1756-9966-27-21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Al-Khatib SM, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017; https://doi.org/10.1161/cir.0000000000000548.

  3. Barbey JT, Pezzullo JC, Soignet SL. Effect of arsenic trioxide on QT interval in patients with advanced malignancies. J Clin Oncol. 2003;21:3609–15. https://doi.org/10.1200/jco.2003.10.009.

    Article  CAS  PubMed  Google Scholar 

  4. Barlogie B, et al. Thalidomide and hematopoietic-cell transplantation for multiple myeloma. N Engl J Med. 2006;354:1021–30. https://doi.org/10.1056/NEJMoa053583.

    Article  CAS  PubMed  Google Scholar 

  5. Barni S, Petrelli F, Cabiddu M. Cardiotoxicity of antiemetic drugs in oncology: an overview of the current state of the art. Crit Rev Oncol Hematol. 2016;102:125–34. https://doi.org/10.1016/j.critrevonc.2016.04.012.

    Article  PubMed  Google Scholar 

  6. Behling J, Kaes J, Munzel T, Grabbe S, Loquai C. New-onset third-degree atrioventricular block because of autoimmune-induced myositis under treatment with anti-programmed cell death-1 (nivolumab) for metastatic melanoma. Melanoma Res. 2017;27:155–8. https://doi.org/10.1097/cmr.0000000000000314.

    Article  CAS  PubMed  Google Scholar 

  7. Benatar A, Decraene T. Comparison of formulae for heart rate correction of QT interval in exercise ECGs from healthy children. Heart. 2001;86:199–202. https://doi.org/10.1136/heart.86.2.199.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Bodley A, et al. DNA topoisomerase II-mediated interaction of doxorubicin and daunorubicin congeners with DNA. Cancer Res. 1989;49:5969–78.

    CAS  PubMed  Google Scholar 

  9. Cheng CW, Yang NI, Ng KK, Cherng WJ. Metastatic cardiac tumor presenting as atrial fibrillation in a previously healthy woman: a case report. Medicine. 2017;96:e7649. https://doi.org/10.1097/md.0000000000007649.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chung MK, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation. 2001;104:2886–91.

    Article  CAS  PubMed  Google Scholar 

  11. Connolly SJ, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51. https://doi.org/10.1056/NEJMoa0905561.

    Article  CAS  PubMed  Google Scholar 

  12. Darby SC, et al. Radiation-related heart disease: current knowledge and future prospects. Int J Radiat Oncol Biol Phys. 2010;76:656–65. https://doi.org/10.1016/j.ijrobp.2009.09.064.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Drew BJ, et al. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. Circulation. 2010;121:1047–60. https://doi.org/10.1161/circulationaha.109.192704.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Emch GS, Hermann GE, Rogers RC. Tumor necrosis factor-α inhibits physiologically identified dorsal motor nucleus neurons in vivo. Brain Res. 2002;951:311–5. https://doi.org/10.1016/S0006-8993(02)03178-5.

    Article  CAS  PubMed  Google Scholar 

  15. Faderl S, et al. A randomized study of clofarabine versus clofarabine plus low-dose cytarabine as front-line therapy for patients aged 60 years and older with acute myeloid leukemia and high-risk myelodysplastic syndrome. Blood. 2008;112:1638–45. https://doi.org/10.1182/blood-2007-11-124602.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Fahdi IE, et al. Bradycardia during therapy for multiple myeloma with thalidomide. Am J Cardiol. 2004;93:1052–5. https://doi.org/10.1016/j.amjcard.2003.12.061.

    Article  CAS  PubMed  Google Scholar 

  17. Fernando HC, Jaklitsch MT, Walsh GL, Tisdale JE, Bridges CD, Mitchell JD, Shrager JB. The Society of Thoracic Surgeons practice guideline on the prophylaxis and management of atrial fibrillation associated with general thoracic surgery: executive summary. Ann Thorac Surg. 2011;92:1144–52. https://doi.org/10.1016/j.athoracsur.2011.06.104.

    Article  PubMed  Google Scholar 

  18. Ficker E, et al. Mechanisms of arsenic-induced prolongation of cardiac repolarization. Mol Pharmacol. 2004;66:33–44. https://doi.org/10.1124/mol.66.1.33.

    Article  CAS  PubMed  Google Scholar 

  19. Frendl G, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. J Thorac Cardiovasc Surg. 2014;148:e153–93. https://doi.org/10.1016/j.jtcvs.2014.06.036.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Futatani T, Watanabe C, Baba Y, Tsukada S, Ochs HD. Bruton’s tyrosine kinase is present in normal platelets and its absence identifies patients with X-linked agammaglobulinaemia and carrier females. Br J Haematol. 2001;114:141–9.

    Article  CAS  PubMed  Google Scholar 

  21. Ghatalia P, Je Y, Kaymakcalan MD, Sonpavde G, Choueiri TK. QTc interval prolongation with vascular endothelial growth factor receptor tyrosine kinase inhibitors. Br J Cancer. 2014;112:296. https://doi.org/10.1038/bjc.2014.564.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Gomez DR, et al. Prospective exploratory analysis of cardiac biomarkers and electrocardiogram abnormalities in patients receiving thoracic radiation therapy with high-dose heart exposure. J Thorac Oncol: Off Publ Int Assoc Study Lung Cancer. 2014;9:1554–60. https://doi.org/10.1097/jto.0000000000000306.

    Article  CAS  Google Scholar 

  23. Granger CB, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92. https://doi.org/10.1056/NEJMoa1107039.

    Article  CAS  PubMed  Google Scholar 

  24. Grant JD, et al. Radiotherapy-induced malfunction in contemporary cardiovascular implantable electronic devices: clinical incidence and predictors. JAMA Oncol. 2015;1:624–32. https://doi.org/10.1001/jamaoncol.2015.1787.

    Article  PubMed  Google Scholar 

  25. Hong RA, Iimura T, Sumida KN, Eager RM. Cardio-oncology/onco-cardiology. Clin Cardiol. 2010;33:733–7. https://doi.org/10.1002/clc.20823.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Indik JH, Pearson EC, Fried K, Woosley RL. Bazett and Fridericia QT correction formulas interfere with measurement of drug-induced changes in QT interval. Heart Rhythm. 2006;3:1003–7. https://doi.org/10.1016/j.hrthm.2006.05.023.

    Article  PubMed  Google Scholar 

  27. Indik JH, et al. 2017 HRS expert consensus statement on magnetic resonance imaging and radiation exposure in patients with cardiovascular implantable electronic devices. Heart Rhythm. 2017;14:e97–e153. https://doi.org/10.1016/j.hrthm.2017.04.025.

    Article  PubMed  Google Scholar 

  28. Isbister GK, Page CB. Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice. Br J Clin Pharmacol. 2013;76:48–57. https://doi.org/10.1111/bcp.12040.

    Article  PubMed  Google Scholar 

  29. Iwata N, Karasawa M, Omine M, Maekawa T, Suzuki T, Kawai Y. Aclarubicin-associated QTc prolongation and ventricular fibrillation. Cancer Treat Rep. 1984;68:527–9.

    CAS  PubMed  Google Scholar 

  30. January CT, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. 2014; 64:e1–e76 https://doi.org/10.1016/j.jacc.2014.03.022.

    Article  PubMed  Google Scholar 

  31. Johnson JN, Ackerman MJ. QTc: how long is too long? Br J Sports Med. 2009;43:657–62. https://doi.org/10.1136/bjsm.2008.054734.

    Article  CAS  PubMed  Google Scholar 

  32. Kalin R, Stanton MS. Current clinical issues for MRI scanning of pacemaker and defibrillator patients. Pacing Clin Electrophysiol: PACE. 2005;28:326–8. https://doi.org/10.1111/j.1540-8159.2005.50024.x.

    Article  PubMed  Google Scholar 

  33. Kaur A, Yu SS, Lee AJ, Chiao TB. Thalidomide-induced sinus bradycardia. Ann Pharmacother. 2003;37:1040–3. https://doi.org/10.1345/aph.1D003.

    Article  PubMed  Google Scholar 

  34. Khan MA, Masood N, Husain N, Ahmad B, Aziz T, Naeem A. A retrospective study of cardiotoxicities induced by 5-fluouracil (5-FU) and 5-FU based chemotherapy regimens in Pakistani adult cancer patients at Shaukat Khanum Memorial Cancer Hospital & Research Center JPMA. J Pak Med Assoc. 2012;62:430–4.

    PubMed  Google Scholar 

  35. Khozin S, et al. FDA approval: ceritinib for the treatment of metastatic anaplastic lymphoma kinase-positive non-small cell lung cancer. Clin Cancer Res: Off J Am Assoc Cancer Res. 2015;21:2436–9. https://doi.org/10.1158/1078-0432.Ccr-14-3157.

    Article  CAS  Google Scholar 

  36. Kilickap S, Barista I, Akgul E, Aytemir K, Aksoy S, Tekuzman G. Early and late arrhythmogenic effects of doxorubicin. South Med J. 2007;100:262–5. https://doi.org/10.1097/01.smj.0000257382.89910.fe.

    Article  PubMed  Google Scholar 

  37. Kim PY, Ewer MS. Chemotherapy and QT prolongation: overview with clinical perspective. Curr Treat Options Cardiovasc Med. 2014;16:303. https://doi.org/10.1007/s11936-014-0303-8.

    Article  PubMed  Google Scholar 

  38. Kupari M, Volin L, Suokas A, Timonen T, Hekali P, Ruutu T. Cardiac involvement in bone marrow transplantation: electrocardiographic changes, arrhythmias, heart failure and autopsy findings. Bone Marrow Transplant. 1990;5:91–8.

    CAS  PubMed  Google Scholar 

  39. Kuryshev YA, Brown AM, Wang L, Benedict CR, Rampe D. Interactions of the 5-hydroxytryptamine 3 antagonist class of antiemetic drugs with human cardiac ion channels. J Pharmacol Exp Ther. 2000;295:614–20.

    CAS  PubMed  Google Scholar 

  40. Larkin J, et al. Vemurafenib in patients with BRAF(V600) mutated metastatic melanoma: an open-label, multicentre, safety study. Lancet Oncol. 2014;15:436–44. https://doi.org/10.1016/s1470-2045(14)70051-8.

    Article  CAS  PubMed  Google Scholar 

  41. Lepeschkin E, Surawicz B. The measurement of the Q-T interval of the electrocardiogram. Circulation. 1952;6:378–88.

    Article  CAS  PubMed  Google Scholar 

  42. Luo S, Michler K, Johnston P, Macfarlane PW. A comparison of commonly used QT correction formulae: the effect of heart rate on the QTc of normal ECGs. J Electrocardiol. 2004;37(Suppl):81–90.

    Article  PubMed  Google Scholar 

  43. Margolin KA, et al. Interleukin-2 and lymphokine-activated killer cell therapy of solid tumors: analysis of toxicity and management guidelines. J Clin Oncol. 1989;7:486–98. https://doi.org/10.1200/jco.1989.7.4.486.

    Article  CAS  PubMed  Google Scholar 

  44. Mazur M, et al. Burden of cardiac arrhythmias in patients with anthracycline-related cardiomyopathy. JACC: Clin Electrophysiol. 2017;3:139–50. https://doi.org/10.1016/j.jacep.2016.08.009.

    Article  Google Scholar 

  45. McGuire WP, Rowinsky EK, Rosenshein NB, Grumbine FC, Ettinger DS, Armstrong DK, Donehower RC. Taxol: a unique antineoplastic agent with significant activity in advanced ovarian epithelial neoplasms. Ann Intern Med. 1989;111:273–9.

    Article  CAS  PubMed  Google Scholar 

  46. Mikami Y, et al. Focal fibrosis in the left ventricle of subjects with cardiac amyloidosis evaluated by multislice computed tomography. Int J Cardiol. 2007;122:72–5. https://doi.org/10.1016/j.ijcard.2006.11.036.

    Article  PubMed  Google Scholar 

  47. Miller RP, Tadagavadi RK, Ramesh G, Reeves WB. Mechanisms of cisplatin nephrotoxicity. Toxins. 2010;2:2490–518. https://doi.org/10.3390/toxins2112490.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Miyake CY, et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical therapy for ventricular tachycardia. J Am Coll Cardiol. 2011;58:1903–9. https://doi.org/10.1016/j.jacc.2011.08.005.

    Article  PubMed  Google Scholar 

  49. Morcos PN, et al. Effect of alectinib on cardiac electrophysiology: results from intensive electrocardiogram monitoring from the pivotal phase II NP28761 and NP28673 studies. Cancer Chemother Pharmacol. 2017;79:559–68. https://doi.org/10.1007/s00280-017-3253-5.

    Article  CAS  PubMed  Google Scholar 

  50. Narducci ML, et al. A challenging case of ventricular arrhythmia in a patient with myocarditis: ICD yes/no after ablation. J Atrial Fibrillation. 2014;7:1121. https://doi.org/10.4022/jafib.1121.

    Article  Google Scholar 

  51. Nazarian S, et al. Safety of magnetic resonance imaging in patients with cardiac devices. N Engl J Med. 2017;377:2555–64. https://doi.org/10.1056/NEJMoa1604267.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Obers S, et al. Multiple mechanisms of hERG liability: K+ current inhibition, disruption of protein trafficking, and apoptosis induced by amoxapine. Naunyn Schmiedeberg’s Arch Pharmacol. 2010;381:385–400. https://doi.org/10.1007/s00210-010-0496-7.

    Article  CAS  Google Scholar 

  53. Ohnishi K, Yoshida H, Shigeno K, et al. Prolongation of the qt interval and ventricular tachycardia in patients treated with arsenic trioxide for acute promyelocytic leukemia. Ann Intern Med. 2000;133:881–5. https://doi.org/10.7326/0003-4819-133-11-200012050-00012.

    Article  CAS  PubMed  Google Scholar 

  54. Olivieri A, et al. Paroxysmal atrial fibrillation after high-dose melphalan in five patients autotransplanted with blood progenitor cells. Bone Marrow Transplant. 1998;21:1049–53. https://doi.org/10.1038/sj.bmt.1701217.

    Article  CAS  PubMed  Google Scholar 

  55. Ou SH, Tang Y, Polli A, Wilner KD, Schnell P. Factors associated with sinus bradycardia during crizotinib treatment: a retrospective analysis of two large-scale multinational trials (PROFILE 1005 and 1007). Cancer Med. 2016;5:617–22. https://doi.org/10.1002/cam4.622.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Patel MR, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91. https://doi.org/10.1056/NEJMoa1009638.

    Article  CAS  PubMed  Google Scholar 

  57. Patell R, Gutierrez A, Rybicki L, Khorana AA. Usefulness of CHADS2 and CHA2DS2-VASc scores for stroke prediction in patients with cancer and atrial fibrillation. Am J Cardiol. 2017;120:2182–6. https://doi.org/10.1016/j.amjcard.2017.08.038.

    Article  PubMed  Google Scholar 

  58. Peres E, et al. Cardiac complications in patients undergoing a reduced-intensity conditioning hematopoietic stem cell transplantation. Bone Marrow Transplant. 2010;45:149–52. https://doi.org/10.1038/bmt.2009.97.

    Article  CAS  PubMed  Google Scholar 

  59. Polk A, Vaage-Nilsen M, Vistisen K, Nielsen DL. Cardiotoxicity in cancer patients treated with 5-fluorouracil or capecitabine: a systematic review of incidence, manifestations and predisposing factors. Cancer Treat Rev. 2013;39:974–84. https://doi.org/10.1016/j.ctrv.2013.03.005.

    Article  CAS  PubMed  Google Scholar 

  60. Porta-Sanchez A, Gilbert C, Spears D, Amir E, Chan J, Nanthakumar K, Thavendiranathan P. Incidence, diagnosis, and management of QT prolongation induced by cancer therapies: a systematic review. J Am Heart Assoc. 2017;6. https://doi.org/10.1161/jaha.117.007724.

  61. Rajkumar SV, et al. Thalidomide as initial therapy for early-stage myeloma. Leukemia. 2003;17:775–9. https://doi.org/10.1038/sj.leu.2402866.

    Article  CAS  PubMed  Google Scholar 

  62. Rapp JH, Yuen M, Abraham T. Bradycardia after intravenous ondansetron with asystole on rechallenge: a case report. Hosp Pharm. 2015;50:918–21. https://doi.org/10.1310/hpj5010-918.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Russo RJ, et al. Assessing the risks associated with MRI in patients with a pacemaker or defibrillator. N Engl J Med. 2017;376:755–64. https://doi.org/10.1056/NEJMoa1603265.

    Article  PubMed  Google Scholar 

  64. Saccullo G, Malato A, Raso S, Santoro M, Zammit V, Casuccio A, Siragusa S. Cancer patients requiring interruption of long-term warfarin because of surgery or chemotherapy induced thrombocytopenia: the use of fixed sub-therapeutic doses of low-molecular weight heparin. Am J Hematol. 2012;87:388–91. https://doi.org/10.1002/ajh.23122.

    Article  CAS  PubMed  Google Scholar 

  65. Salerno F, Girerd N, Chalabreysse L, Billaud G, Lina B, Chevalier P. Myocarditis and cardiac channelopathies: a deadly association? Int J Cardiol. 2011;147:468–70. https://doi.org/10.1016/j.ijcard.2011.01.019.

    Article  PubMed  Google Scholar 

  66. Sanguinetti MC, Mitcheson JS. Predicting drug–hERG channel interactions that cause acquired long QT syndrome. Trends Pharmacol Sci. 2005;26:119–24. https://doi.org/10.1016/j.tips.2005.01.003.

    Article  CAS  PubMed  Google Scholar 

  67. Sato Y, et al. Lipomatous hypertrophy of the interatrial septum presenting as sick sinus syndrome. Int J Cardiol. 2007;119:280–1. https://doi.org/10.1016/j.ijcard.2006.07.161.

    Article  PubMed  Google Scholar 

  68. Shah S, Norby FL, Datta YH, Lutsey PL, MacLehose RF, Chen LY, Alonso A. Comparative effectiveness of direct oral anticoagulants and warfarin in patients with cancer and atrial fibrillation. Blood Adv. 2018;2:200–9. https://doi.org/10.1182/bloodadvances.2017010694.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Sharabi Y, Dendi R, Holmes C, Goldstein DS. Baroreflex failure as a late sequela of neck irradiation. Hypertension (Dallas, Tex: 1979). 2003;42:110–6. https://doi.org/10.1161/01.Hyp.0000077441.45309.08.

    Article  CAS  Google Scholar 

  70. Shen S, Rizkallah J, Kirkpatrick ID, Khadem A, Jassal DS. Cardiac lipofibromatosis. Can J Cardiol. 2013;29:519.e511–2. https://doi.org/10.1016/j.cjca.2012.08.018.

    Article  Google Scholar 

  71. Shigeno K, et al. Arsenic trioxide therapy in relapsed or refractory Japanese patients with acute promyelocytic leukemia: updated outcomes of the phase II study and postremission therapies. Int J Hematol. 2005;82:224–9. https://doi.org/10.1532/ijh97.05044.

    Article  CAS  PubMed  Google Scholar 

  72. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68:7–30. https://doi.org/10.3322/caac.21442.

    Article  PubMed  Google Scholar 

  73. Soignet SL, et al. United States multicenter study of arsenic trioxide in relapsed acute promyelocytic leukemia. J Clin Oncol. 2001;19:3852–60. https://doi.org/10.1200/jco.2001.19.18.3852.

    Article  CAS  PubMed  Google Scholar 

  74. Stroeder J, Evans C, Mansell H. Corticosteroid-induced bradycardia: case report and review of the literature. Can Pharmacists J: CPJ = Rev Pharmaciens Can: RPC. 2015;148:235–40. https://doi.org/10.1177/1715163515597451.

    Article  Google Scholar 

  75. Subramanian R, Flygenring B. Mesothelioma of the atrioventricular node and congenital complete heart block. Clin Cardiol. 1989;12:469–72.

    Article  CAS  PubMed  Google Scholar 

  76. Tötterman KJ, Pesonen E, Siltanen P. Radiation-related chronic heart disease. Chest. 1983;83:875–8. https://doi.org/10.1378/chest.83.6.875.

    Article  PubMed  Google Scholar 

  77. Unnikrishnan D, et al. Torsades de pointes in 3 patients with leukemia treated with arsenic trioxide. Blood. 2001;97:1514–6.

    Article  CAS  PubMed  Google Scholar 

  78. Vaduganathan M, Patel NK, Lubitz SA, Neilan TG, Dudzinski DM. A “Malignant” arrhythmia: cardiac metastasis and ventricular tachycardia. Tex Heart Inst J. 2016;43:558–9. https://doi.org/10.14503/thij-15-5189.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Vaporciyan AA, et al. Risk factors associated with atrial fibrillation after noncardiac thoracic surgery: analysis of 2588 patients. J Thorac Cardiovasc Surg. 2004;127:779–86. https://doi.org/10.1016/j.jtcvs.2003.07.011.

    Article  PubMed  Google Scholar 

  80. Viskin S, et al. Inaccurate electrocardiographic interpretation of long QT: the majority of physicians cannot recognize a long QT when they see one. Heart Rhythm. 2005;2:569–74. https://doi.org/10.1016/j.hrthm.2005.02.011.

    Article  PubMed  Google Scholar 

  81. Xu MF, Tang PL, Qian ZM, Ashraf M. Effects by doxorubicin on the myocardium are mediated by oxygen free radicals. Life Sci. 2001;68:889–901. https://doi.org/10.1016/S0024-3205(00)00990-5.

    Article  CAS  PubMed  Google Scholar 

  82. Yeh ET, Bickford CL. Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. J Am Coll Cardiol. 2009;53:2231–47. https://doi.org/10.1016/j.jacc.2009.02.050.

    Article  CAS  PubMed  Google Scholar 

  83. Yilmaz U, et al. 5-fluorouracil increases the number and complexity of premature complexes in the heart: a prospective study using ambulatory ECG monitoring. Int J Clin Pract. 2007;61:795–801. https://doi.org/10.1111/j.1742-1241.2007.01323.x.

    Article  CAS  PubMed  Google Scholar 

  84. Yusuf SW, Razeghi P, Yeh ET. The diagnosis and management of cardiovascular disease in cancer patients. Curr Probl Cardiol. 2008;33:163–96. https://doi.org/10.1016/j.cpcardiol.2008.01.002.

    Article  PubMed  Google Scholar 

  85. Zaremba T, Jakobsen AR, Sogaard M, Thogersen AM, Johansen MB, Madsen LB, Riahi S. Risk of device malfunction in cancer patients with implantable cardiac device undergoing radiotherapy: a population-based cohort study. Pacing Clin Electrophysiol: PACE. 2015;38:343–56. https://doi.org/10.1111/pace.12572.

    Article  PubMed  Google Scholar 

  86. Zhang S, Liu X, Bawa-Khalfe T, Lu L-S, Lyu YL, Liu LF, Yeh ETH. Identification of the molecular basis of doxorubicin-induced cardiotoxicity. Nat Med. 2012;18:1639. https://doi.org/10.1038/nm.2919. https://www.nature.com/articles/nm.2919#supplementary-information

    Article  CAS  PubMed  Google Scholar 

  87. Zimmer L, et al. Neurological, respiratory, musculoskeletal, cardiac and ocular side-effects of anti-PD-1 therapy. Eur J Cancer (Oxford, England: 1990). 2016;60:210–25. https://doi.org/10.1016/j.ejca.2016.02.024.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Peter Kim, Abdulrazzak Zarifa, Mohammed Salih & Kaveh Karimzad

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  1. Peter Kim
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  2. Abdulrazzak Zarifa
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  3. Mohammed Salih
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  4. Kaveh Karimzad
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Correspondence to Peter Kim .

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  1. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Joseph L. Nates

  2. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Kristen J. Price

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Kim, P., Zarifa, A., Salih, M., Karimzad, K. (2019). Arrhythmias in Cancer Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74698-2_68-1

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