Clinical Electrophysiology -> Ventricular Arrhythmias -> Clinical Trials / Outcomes D-PO05 - Poster Session V (ID 39) Poster

D-PO05-224 - Arrhythmogenic Cardiotoxicity Associated With Contemporary Chemotherapeutic Agents (ID 1317)


Background: Cardiac complications of cancer chemotherapy (CC) are recognized as major contributors to morbidity and mortality in cancer survivors. However, the rate of arrhythmic events associated with contemporary CC is not well defined.
Objective: We aimed to study arrhythmic burden associated with contemporary CC agents for lymphoproliferative disorders.
Methods: The study population comprised 2266 patients diagnosed with lymphoproliferative disorders who were followed-up at URMC from January 2013 through November 2019. 1124 patients were treated with CC agents (CC-group) and 1142 were not (non-CC group). The primary endpoint was sudden cardiac death (SCD). Secondary endpoints included nonfatal ventricular and atrial arrhythmias and a composite of fatal or nonfatal arrhythmic events. Mortality and arrhythmic events were adjudicated by an independent committee.
Results: Mean age was 61 ± 16 years and 41% were female. The rate of fatal or nonfatal arrhythmic events at 1-year was significantly higher in the CC compared to the non-CC group (p<0.001; Figure A). Of the 182 mortality events in the CC group, 16 (9%) were adjudicated as cardiac and 11 of these cardiac deaths (6%) were adjudicated as SCD. Nonfatal arrhythmias during CC occurred in 379 patients, of which 15 (4%) were sustained ventricular; 222 (38%) sustained atrial; and 142 (37%) were non-sustained ventricular or atrial. The rate of arrhythmic events by the type of CC agent is shown in Figure B.
Conclusion: Contemporary CC is associated with a significant arrhythmic burden, including sustained ventricular events and SCD. These findings suggest a need for appropriate preventive and protective measures in at risk patients.