Introducing a new entity: chemotherapy-induced arrhythmia

Abstract

The relationship between chemotherapy and arrhythmias has not been well established. We reviewed the existing literature to better understand this connection. We reviewed published reports on chemotherapy-induced arrhythmias in English using the PubMed/Medline and OVID databases from 1950 onwards as well as lateral references. Arrhythmias were reported as a side effect of many chemotherapeutic drugs. Anthracyclines are associated with atrial fibrillation (AF) at a rate of 2–10%, but rarely with ventricular tachycardia (VT)/fibrillation. Taxol and other antimicrotubular drugs are safe in terms of pro-arrhythmic side effects and do not cause any consistent rhythm abnormalities. Arrhythmias induced by 5-fluorouracil, including VT, are mostly ischaemic in origin and usually occur in the context of coronary spasm produced by this drug. Cisplatin—particularly with intrapericardial use—is associated with a very high rate of AF (12–32%). Melphalan is associated with AF in 7–12% of cases, but it does not appear to cause VT. Interleukin-2 is linked to frequent arrhythmia, mostly AF. We summarized the available data on chemotherapy-induced arrhythmia, particularly AF and VT. Studies with prospective data collection and thorough analyses are needed to establish a causal relationship between certain anticancer drugs and arrhythmia.