Clinical presentations, diagnosis, and management of arrhythmias associated with cardiac tumors

Abstract

Cardiac tumors are a rare cause of arrhythmias in clinical practice. They can cause a broad spectrum of arrhythmias, from low-grade ectopics to incessant ventricular tachycardias, including sudden cardiac arrest. Both primary and secondary cardiac tumors can produce arrhythmias, but not all tumors cause arrhythmias. Although cardiac tumors can cause arrhythmias in fetuses and older adults alike, only specific cardiac tumors are the underlying cause of arrhythmia in different age groups. This article reviews various cardiac tumors that are associated with arrhythmias, their clinical presentations, diagnostic features, and management.

Keywords: arrhythmias; cardiac tumors; incessant tachycardias; pediatric arrhythmias; sudden death.

Figure 1

A 12‐lead electrocardiogram of a 25‐year‐old man with palpitations and presyncope shows a left bundle branch morphology left axis ventricular tachycardia at a rate of 215 beats per minute

Figure 2

A 12‐lead electrocardiogram of the same patient as in Figure 1 in sinus rhythm shows monomorphic ventricular ectopics with a morphology similar of that of VT (* in rhythm strip). T inversion in inferolateral leads is also noted. LBBB, left bundle branch block; VT, ventricular tachycardia

Figure 3

Cardiac magnetic resonance imaging: A, B, T1‐weighted images reveal a circumscribed hyperintense mass located subepicardially to the lateral and inferior aspects of the RA and RV. C, D, A comparison of a T1 image (C) and a fat suppression sequence (D) of the subepicardial mass in the same view. The radiolucent appearance of the mass in the subepicardial location in fat‐suppressed sequences suggests a lipoma. E, Gross appearance of the excised tumor shows a large circumscribed, encapsulated, bilobed tumor measuring 10 × 10 × 9 cm with an intervening stalk. RA, right atrium; RV, right ventricle. (From Ref. 26 with permission)