Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with cancer. Indeed, cancer patients have a significantly higher incidence of AF than that observed in the general population. A reciprocal relationship between these two diseases has been observed, as much as some assume AF to be a marker for occult cancer screening, especially in older adults. The pathophysiological mechanisms are many and varied, including the underlying pro-inflammatory state, specific treatments (chemo- and radiotherapy), and surgery. The therapeutic management of patients with cancer and AF involves the same rhythm and frequency control strategies as the general population; however, the numerous interactions with chemotherapeutics, which lead to a significant increase in side effects, as well as the extreme fragility of the patient, should be considered. Anticoagulant therapy is also a complex challenge to address, as bleeding and stroke risk scores have not been fully assessed in this subpopulation. Furthermore, in large studies establishing the efficacy of direct oral anticoagulants (DOACs), cancer patients have been underrepresented. In this review, we elaborate on the mechanisms linking AF to cancer patients with a particular focus on the therapeutic challenges in this population.
心房颤动（AF）是癌症患者中日益受到重视的共病。事实上，癌症患者的心房颤动发病率显著高于普通人群。这两种疾病之间存在相互关联，甚至有人认为心房颤动可作为隐匿性癌症筛查的标志，尤其在老年人群中。其病理生理机制复杂多样，包括潜在的促炎症状态、特定治疗（化疗与放疗）以及手术影响。癌症合并心房颤动患者的治疗管理采用与普通人群相同的心律与频率控制策略；然而，需特别考虑化疗药物引发的多重相互作用（导致副作用显著增加）以及患者的极度脆弱性。抗凝治疗同样面临复杂挑战，因为该亚群患者的出血与卒中风险评分尚未得到充分评估。此外，在确立直接口服抗凝药（DOACs）疗效的大型研究中，癌症患者的代表性明显不足。本综述将详细阐述心房颤动与癌症患者的关联机制，并重点探讨该人群面临的治疗挑战。
Current Data and Future Perspectives on Patients with Atrial Fibrillation and Cancer
肿瘤(癌症)患者之家