Garibaldi Silvia, Chianca Michela, Fabiani Iacopo, Emdin Michele, Piacenti Marcello, Passino Claudio, Aimo Alberto, Fedele Antonella, Cipolla Carlo Maria, Cardinale Daniela Maria
Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy.
Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, 56127 Pisa, Italy.
J Clin Med. 2022 Jul 30;11(15):4452. doi: 10.3390/jcm11154452.
Longer life expectancy along with advancements in cancer and atrial fibrillation (AF) therapies and treatment strategies have led to an increase in the number of individuals with both diseases. As a result, the complicated management of these patients has become crucial, necessitating individualised treatment that considers the bi-directional relationship between these two diseases. On the one hand, giving appropriate pharmaceutical therapy is exceptionally difficult, considering the recognised thromboembolic risk posed by AF and malignancy, as well as the haemorrhagic risk posed by cancer. The alternative pulmonary vein isolation (PVI) ablation, on the other hand, has been inadequately explored in the cancer patient population; there is yet inadequate data to allow the clinician to unambiguously select patients that can undertake this therapeutic intervention. The goal of this review is to compile the most valuable data and supporting evidence about the characteristics, care, and therapy of cancer patients with AF. Specifically, we will evaluate the pharmaceutical options for a proper anticoagulant therapy, as well as the feasibility and safety of PVI in this population.
预期寿命的延长，以及癌症和心房颤动（AF）治疗及治疗策略的进步，导致同时患有这两种疾病的人数增加。因此，对这些患者进行复杂的管理变得至关重要，需要考虑这两种疾病之间双向关系的个体化治疗。一方面，考虑到AF和恶性肿瘤带来的公认血栓栓塞风险以及癌症带来的出血风险，给予适当的药物治疗异常困难。另一方面，替代性肺静脉隔离（PVI）消融在癌症患者群体中的研究尚不充分；目前尚无足够的数据让临床医生明确选择能够接受这种治疗干预的患者。本综述的目的是汇编有关AF癌症患者的特征、护理和治疗的最有价值的数据及支持证据。具体而言，我们将评估适当抗凝治疗的药物选择，以及PVI在该人群中的可行性和安全性。
