Background: Ibrutinib increases the risk of atrial fibrillation (AF) and is associated with bleeding tendencies. Reported rates of arrhythmia are variable in different studies. The aim of the current analysis was to evaluate the incidence of AF in a single center cohort of patients.
Methods: This analysis was conducted at Hunter New England Local Health District, Australia between 1 April 2015 and 30 June 2017. We included all consecutive patients commenced on ibrutinib for haematological malignancies. Patients with a history of paroxysmal AF were excluded. The primary end point was incidence of AF. Time to diagnosis and management were secondary outcomes of interest.
Results: A total of 24 patients (age 73±9 years, males n=16 (67%)) were commenced on ibrutinib treatment during the study period with chronic lymphocytic leukemia (n=21, 88%) as the main indication. During a median follow up of 12 months, 4 (17%) patients were diagnosed with AF with increasing age, duration of ibrutinib treatment as associations. The median time to AF diagnosis was 9 (IQR: 7 – 18) months. All patients were managed with a rate control strategy with beta blockers as the preferred agents. 3 (75%) patients were commenced on anticoagulation for stroke prevention. During a follow up of 18 (IQR: 17 – 23) months following AF onset, 1 patient required hospitalization for AF. There were no bleeding complications reported.
Conclusions: In conclusion, this series noted a higher incidence of AF than previously reported. Oncologists and cardiologists need to be aware of the increased risk of AF in patients receiving ibrutinib.