Author + information
- Received October 7, 2013
- Revision received October 30, 2013
- Accepted November 19, 2013
- Published online March 18, 2014.
- ∗First Department of Internal Medicine, University of Athens Medical School, Athens, Greece
- †Second Department of Cardiology, University of Athens Medical School, Athens, Greece
- ↵∗Reprint requests and correspondence:
Dr. Gerasimos Filippatos, Second Department of Cardiology, University of Athens Medical School, Attikon Hospital, 1 Rimini Street, Athens, Greece.
Atrial fibrillation (AF) has been found to occur with an increased frequency in patients with malignancies, particularly in those undergoing cancer surgery. The occurrence of AF in cancer may be related to comorbid states or a direct tumor effect or may represent a complication of cancer surgical or medical therapy, whereas inflammation may be a common denominator for both conditions. Treating AF in patients with malignancies is a challenge, especially in terms of antithrombotic therapy, because cancer may result in an increased risk of either thrombosis or hemorrhage and an unpredictable anticoagulation response, whereas thromboembolic risk prediction scores such as CHADS2 (Cardiac Failure, Hypertension, Age, Diabetes, and Stroke [doubled]) may not be applicable. The general lack of evidence imposes an individualized approach to the management of AF in those patients, although some general recommendations based on current guidelines in noncancer patients and the existing evidence in cancer patients, where available, may be outlined.
This paper was partly supported by a grant from the Hellenic Cardiological Society. Dr. Farmakis is a member of the Steering Committee for a trial sponsored by Boehringer-Ingelheim Ellas. Dr. Parissis has received research grants from Abbott USA and ORION Pharma for heart failure; and has received honoraria from Servier International and Menarini International for lectures. Dr. Filippatos is a member of the Steering Committee for trials sponsored by Bayer and Corthera.
- Received October 7, 2013.
- Revision received October 30, 2013.
- Accepted November 19, 2013.
- American College of Cardiology Foundation