Abstract 16113: Similar Rates and Risk of Atrial and Ventricular Arrhythmias in Patients With Chemotherapy-induced Cardiomyopathy Compared to Other Forms of Non-ischemic Cardiomyopathy
Introduction: Chemotherapy induced cardiomyopathy (CIC) is a frequently identified cardiovascular complication of cancer therapy, especially with the use of anthracyclines. A proportion of these patients will require implantation of a defibrillator (ICD) for the prevention of sudden cardiac death. There is little information about arrhythmia burden in CIC patients.
Hypothesis: We hypothesize that CIC patients will have similar rates and adjusted risk of atrial and ventricular arrhythmias compared to patients with other forms of non-ischemic cardiomyopathy (CMP).
Methods: We performed a retrospective review of patients regularly followed in the University of South Florida device clinic, identifying 9 patients with CIC and an ICD and 18 age- and gender-matched control patients (9 non-ischemic and 9 ischemic CMP patients) for a total cohort of 27 patients. We excluded any patients who received an ICD for secondary prevention or those with high risk arrhythmic substrates. The odds of arrhythmias and ICD shocks were calculated by type of CMP, adjusted for days since ICD implant and atrial fibrillation history.
Results: All CIC patients had breast cancer or leukemia/lymphoma, with the majority exposed to anthracyclines (86%). Mean time from chemotherapy to device implantation was 12.7 years (range 2-20 years). In our cohort, CIC and other non-ischemic CMP patients were more likely to receive a biventricular ICD than ischemic CMP patients (66.7%, 55.6%, 11.1%; p=0.0002). Compared to non-ischemic CMP patients, rates and adjusted odds were similar for CIC patients for atrial arrhythmias (44.4% vs. 33.3%; OR 1.79; CI 0.17-18.62; p=0.63), non-sustained ventricular tachycardia (NSVT) (44.4% vs. 33.3%; OR 2.13; CI 0.22-20.20; p=0.51), and the combined outcome of NSVT, sustained VT and/or VF (44.4% vs. 44.4%; OR 2.81; CI 0.26-30.09; p=0.11). In contrast, ischemic CMP patients demonstrated significantly higher rates and adjusted odds of the combined outcome (88.9% vs 44.4%; OR 23.74; CI 1.31-430.0; p=0.03).
Conclusion: Rates of atrial and ventricular arrhythmias in patients with CIC appear to be similar to those experienced by patients with non-ischemic CMP. This is one of the first studies to quantitatively evaluate arrhythmia burden in this population.
- Ventricular arrhythmia
- Atrial arrhythmias
- Implantable cardiovertor defibrillator
Author Disclosures: M.G. Fradley: Consultant/Advisory Board; Modest; Ariad Pharmaceuticals. F. Viganego: None. K. Kip: None. A. Martin: None. A. Patel: None. R. Ismail-Khan: None. S. Chae: None. B. Herweg: None. A. Labovitz: None.
- © 2016 by American Heart Association, Inc.