Early and Late Arrhythmogenic Effects of Doxorubicin

Kılıçkap, Saadettin; Barışta, İbrahim; Akgül, Ebru; Aytemir, Kudret; Aksoy, Sercan; Tekuzman, Gülten

doi:10.1097/01.smj.0000257382.89910.fe

Cited by 108 publications

(72 citation statements)

References 18 publications

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“…Acutely after treatment with anthracyclines, Kilickap et al [8] showed that as many as 65% of patients developed arrhythmias. A variety of arrhythmias have been shown to occur, including premature atrial contractions (PACs) in 41% of patients and premature ventricular contractions (PVCs) in 31% of patients, which are unlikely to be clinically significant, as well as atrial fibrillation in 10% of patients, nonsustained ventricular tachycardia (NSVT) in 6% of patients, and rare second-degree and complete heart block requiring pacemaker implantation [9].…”

Section: Discussionmentioning

confidence: 99%

Arrhythmia and Electrophysiological Effects of Chemotherapy: A Review

Markman

Nazarian²

2016

Oncology

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Importance: Cardiotoxicity is an important limiting factor in the use of antineoplastic agents. The risk of arrhythmia and the electrophysiological effects of these agents are poorly characterized though increasing evidence suggests a high prevalence of complications. Observations: Patients with substantial cardiovascular risk factors are often excluded from clinical trials, while the aging population of patients actually receiving therapies may have an underlying arrhythmogenic substrate due to comorbidities. Risk stratification of patients before the selection of a therapeutic regimen is essential. Given the regular use of combination therapies, the potential for arrhythmia of each agent must be fully understood. Despite limited data and understanding in clinical practice, decisions on whether to initiate specific therapies in high-risk patients and how to manage the associated complications are made regularly. Conclusions and Relevance: This review describes the observed arrhythmias and proposed mechanisms for several major classes of antineoplastic agents. It also provides recommendations for risk stratification, monitoring, prophylaxis, and therapy, emphasizing the need for a collaborative relationship between oncologists and cardiologists and areas for future research.

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Section: Discussionmentioning

confidence: 99%

Arrhythmia and Electrophysiological Effects of Chemotherapy: A Review

Markman

Nazarian²

2016

Oncology

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“…Dilated cardiomyopathy and rhythm disturbances are the most well-known side effects of doxorubicin [7,8]. Various electrocardiographical abnormalities including T-wave inversion, ST-segment elevation or depression, decreased QRS voltage, prolonged QT-interval and arrhythmias including AV block, and supraventricular, and ventricular arrhythmias may occur both in the acute and chronic phase after the therapy [12][13][14][15][16][17]. Doxorubicin-associated dilated cardiomyopathy is dose-dependent and, cumulative doxorubicin dose exceeding 450-550 mg/m 2 , the risk of drug-related myocardial toxicity that is manifested as a life-threatening congestive heart failure tends to increase.…”

Section: Discussionmentioning

confidence: 99%

Addition of rituximab to chop does not increase the risk of cardiotoxicity in patients with non-Hodgkin’s lymphoma

et al. 2008

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“…Kilickap et al recorded paroxysmal AF in 10.3% of 29 patients during the first course of doxorubicin-containing chemotherapy [93]. Also, doxorubicin can induce arrhythmia in cardiomyocytes [94].…”

Section: Anthracycline Agentsmentioning

confidence: 98%