Bruton Tyrosine Kinase Inhibitor-Related Atrial Fibrillation: Implications in Treatment

Atrial Fibrillation and Lymphoma Patients: Understanding the Cardiovascular Toxicity Associated with Bruton Tyrosine Kinase Inhibitors

Introduction

Bruton tyrosine kinase inhibitors (BTKi) are targeted therapies that have been used in the treatment of hematologic malignancies including chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenström’s macroglobulinemia. Among the BTKi drugs available, ibrutinib has become a standard treatment for these malignancies. However, the use of ibrutinib has been associated with an increased risk of cardiovascular toxicity, particularly in patients with pre-existing cardiac conditions such as atrial fibrillation (AF).

Atrial Fibrillation and Cardiovascular Toxicity

Atrial fibrillation is a common cardiac arrhythmia that affects millions of people worldwide. Patients with AF have an increased risk of stroke and heart failure, and the use of BTKi drugs such as ibrutinib has been found to exacerbate these risks. Recent studies have shown that patients with AF who are treated with ibrutinib are at a higher risk of developing cardiovascular toxicity such as hypertension, ventricular arrhythmias, and heart failure. Therefore, before starting treatment with BTKi drugs, it is important to assess patients for any pre-existing cardiac conditions and to closely monitor cardiovascular function during treatment.

Alternative Treatments

Sometimes other treatments are necessary when AF patients are undergoing treatment with BTKi drugs. Some alternative treatments for AF include electrical cardioversion, rhythm control medications, and catheter ablation. Electrical cardioversion involves the use of a low-energy shock to restore normal heart rhythm. Rhythm control medications such as beta-blockers, calcium channel blockers, and anti-arrhythmic drugs are also used to treat AF. Catheter ablation involves the destruction of small areas of heart tissue that are causing the arrhythmia.

Conclusion

In conclusion, patients with AF who are treated with BTKi drugs such as ibrutinib are at an increased risk of developing cardiovascular toxicity. Therefore, it is important to closely monitor cardiovascular function during treatment, and to consider alternative treatments if necessary. Healthcare professionals should be aware of these risks and take steps to minimize the risks associated with BTKi therapy in patients with AF and other pre-existing cardiac conditions.

Keywords: Atrial Fibrillation, Bruton tyrosine kinase inhibitors, cardiovascular toxicity, Lymphoma, Ibrutinib

Correspondence: Zou-fang Huang, Ganzhou Key Laboratory of Hematology, Department of Hematology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China.

Originally Post From https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1408983/abstract