心律失常抗癌药物在心脏肿瘤学中的应用

Arrhythmogenic Anticancer Drugs in Cardio-Oncology.

机构信息

Division of Cardiovascular Medicine, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, USA; Cardio-Oncology Program, Moffitt Cancer Center, Tampa, FL 33612, USA.

Cardio-Oncology Program, Moffitt Cancer Center, Tampa, FL 33612, USA; Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, USA.

出版信息

Cardiol Clin. 2019 Nov;37(4):459-468. doi: 10.1016/j.ccl.2019.07.011.

DOI:10.1016/j.ccl.2019.07.011

PMID:31587787

Abstract

Multiple cancer therapies are associated with cardiac arrhythmias through a variety of pathophysiologic mechanisms. Atrial fibrillation and atrial flutter are common during cancer therapy but should rarely limit continued delivery of therapy. Ventricular arrhythmias are not common during cancer therapy and are more often secondary to other cardiac pathologies. QT interval monitoring is recommended for some agents, although it is often not a reliable predictor of ventricular arrhythmias. Bradyarrhythmias are common and rarely require intervention, but special attention must be paid to heart block in checkpoint inhibitor therapy.

摘要

多种癌症治疗方法通过多种病理生理机制与心律失常相关。癌症治疗期间常出现房颤和房扑，但一般不会限制继续治疗。癌症治疗期间很少出现室性心律失常，更常见于继发于其他心脏疾病。某些药物推荐监测 QT 间期，但 QT 间期通常不是室性心律失常的可靠预测指标。缓律失常常见，一般不需要干预，但在检查点抑制剂治疗时必须特别注意心脏阻滞。