Atrial fibrillation in a patient with lung cancer: a case report

Abstract

Introduction. Cancer remains one of the most common causes of death in the world, second only to cardiovascular diseases. The use of novel chemotherapeutic and targeted agents has significantly improved the prognosis of this group of patients. However, this significantly increased the number of cardiotoxic complications of anticancer therapy, including arrhythmias, in particular atrial fibrillation (AF), which negatively affects the prognosis.Brief description. The purpose of this article was to describe the case of a 64-yearold woman with central right lung lower lobe cancer. Upon admission to the chemotherapy department, the patient was first diagnosed with paroxysmal AF. After chemical cardioversion, the first course of multiagent chemotherapy (MAC) was performed as follows: paclitaxel 280 mg and carboplatin 450 mg, which was complicated by the development of recurrent AF episode. During subsequent MAC courses, arrhythmia episodes regularly occurred. During the next AF episode, the patient was hospitalized at the City Clinical Hospital № 51, where she died despite intensive therapy. Postmortem examination ruled out tumor invasion into the left atrium.Discussion. For the AF development, the patient had prerequisites in the form of a significantly remodeled left atrial myocardium. Chemotherapy agents used as antitumor therapy are characterized by the common development of cardiotoxicity, including variety of arrhythmias. The occurrence of AF episodes coincided with the course of MAC, which suggested its cardiotoxic manifestations. Postmortem examination confirmed the high probability of an association between AF episodes and MAC.Conclusion. The presented case illustrates the difficulties encountered by oncologists and cardiologists in determining the genesis and treatment of complex arrhythmias in cancer patients.