Antineoplastic drug-induced bradyarrhythmias

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Anticancer treatments, including chemotherapy and targeted therapies, are associated with significant cardiac toxicities.
• These cardiac side effects range from congestive heart failure to arrhythmias, impacting patient survival and quality of life.

Purpose of the Study:

• To review the evidence linking antineoplastic agents to bradyarrhythmias in adults.
• To summarize the proposed mechanisms of bradyarrhythmia development.
• To provide clinical management recommendations for these cardiotoxic effects.

Main Methods:

• A comprehensive literature search was conducted using Medline and cross-referencing.
• The search focused on anticancer agents and their association with cardiotoxicity, electrocardiographic changes, and arrhythmias.
• Data from clinical trials, observational studies, case reports, and reviews published between 1970 and 2012 were analyzed.

Main Results:

• Specific anticancer agents have been linked to the development of bradyarrhythmias.
• The review details various chemotherapeutic and molecular-targeted drugs implicated in cardiac rhythm disturbances.
• Mechanisms underlying drug-induced bradyarrhythmias were explored.

Conclusions:

• Increased awareness of drug-induced bradyarrhythmias is crucial for risk stratification and patient management.
• Effective management requires collaboration between oncologists, hematologists, and cardiologists.
• Timely intervention and monitoring can mitigate the impact of these cardiac toxicities.