Cardiac Arrhythmias in Patients Treated for Lung Cancer: A Review

Abstract

Cardio-oncology currently faces one of the greatest challenges in the field of health care. The main goal of this discipline is to ensure that patients treated for cancer do not suffer or die from cardiovascular disease. The number of studies on the mechanisms of heart injury during cancer treatment is constantly increasing. However, there is insufficient data on heart rhythm disorders that may result from this treatment. This issue seems to be particularly important in patients with lung cancer, in whom anticancer therapy, especially radiotherapy, may contribute to the onset of cardiac arrhythmias. The observed relationship between cardiac dosimetry and radiotherapy-induced cardiotoxicity in lung cancer treatment may explain the increased mortality from cardiovascular causes in patients after chest irradiation. Further research is essential to elucidate the role of cardiac arrhythmias in this context. Conversely, recent reports have highlighted the application of stereotactic arrhythmia radioablation (STAR) in the treatment of ventricular tachycardia. This review of available studies on the epidemiology, pathogenesis, diagnosis, and treatment of arrhythmias in patients treated for lung cancer aims to draw attention to the need for regular cardiological monitoring in this group of patients. Improving cardiac care for patients with lung cancer has the potential to enhance their overall therapeutic outcomes.

The Interplay Between Cardiovascular Disease and Lung Cancer

“…Taxanes and various TKIs, including alectinib and osimertinib, are associated with sinus bradycardia and changes in heart rhythm, with osimertinib specifically linked with ventricular tachycardia. Immune checkpoint inhibitors, such as pembrolizumab and atezolizumab, can lead to a range of arrhythmias, from sinus tachycardia to complete AV block, and, in rare cases, sudden cardiac death [52].…”