Atrial fibrillation and malignant neoplasms: state of the problem

Abstract

Patients with malignant neoplasms have an increased risk of atrial fibrillation. Prevalence of this pathology among oncological patients is 20–30 %, and it significantly varies depending on tumor type, chemotherapy treatment and initial comorbid status. Atrial fibrillation and malignant neoplasms have similar risk factors. Researchers have identified several possible causes characteristic of these diseases, primarily, systemic inflammation. Some chemotherapies cause abnormalities in ionic channels of atrial cardiomyocytes which leads to changes in the action potential and refractory period, which promote maintenance of atrial fibrillation. The most known groups of chemotherapy drugs associated with atrial fibrillation are alkylating agents (cisplatin, cyclophosphamide), anthracyclines used in sarcoma treatment, as well as anti-HER2 drugs (HER2 – human epidermal growth factor receptor 2), antimetabolites (capecitabine, 5-fluorouracil) and tyrosine kinase inhibitors. However, pathophysiological mechanisms linking together atrial fibrillation and malignant neoplasms require further study.