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Review
. 2025 Mar;14(1):1-15.
doi: 10.1007/s40119-024-00394-1. Epub 2024 Dec 23.

Atrial Fibrillation in Patients with Breast Cancer: A Literature Review

Mozidat Olamide Bello  1 , Mark Wadid  1 , Aishwarya Malode  1 , Vahin Patel  1 , Anuj Shah  1 , Ankit Vyas  2 , Hassaan Ali Ahmad  3 , Tushar Tarun  4 , Sourbha Dani  1 , Javaria Ahmad  1 , Corrine Zarwan  5 , Sarju Ganatra  6
Affiliations
Review

Atrial Fibrillation in Patients with Breast Cancer: A Literature Review

Mozidat Olamide Bello et al. Cardiol Ther. 2025 Mar.

Abstract

In addition to traditional risk factors, patients with breast cancer are at an increased risk of atrial fibrillation due to cancer itself and certain cancer therapies. Atrial fibrillation in these patients adds to their morbidity and mortality. The precise mechanisms leading to the increased atrial fibrillation in patients with breast cancer are not well understood. The main goal of atrial fibrillation management in this population is to facilitate uninterrupted cancer treatment while addressing the arrhythmia and other cardiovascular sequelae of cancer treatment. Rhythm control is often challenging to implement in patients with breast cancer during active antineoplastic therapy because of the need for uninterrupted anticoagulation, potential drug-drug interactions between cancer treatments and antiarrhythmic medications, and the increased likelihood of atrial fibrillation recurrence. Prevention of thromboembolism and anticoagulation can also be challenging in patients with breast cancer as a result of the increased risk of cancer-related procoagulant state and coagulopathies. The integration of a cardio-oncology team and a multidisciplinary approach are crucial for better outcomes. The therapeutic interventions should be tailored toward individual patients' profiles through a shared decision-making approach. The precise mechanisms leading to the increased atrial fibrillation in patients with breast cancer are not well understood, highlighting the gaps in our knowledge. More research is required to reduce these gaps, refine risk stratification, and optimize treatment strategies in these patients.

Keywords: Atrial fibrillation; Breast cancer; Cardio-oncology.

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Conflict of interest statement

Declarations. Conflict of Interest: Mozidat Olamide Bello, Mark Wadid, Aishwarya Malode, Vahin Patel, Anuj Shah, Ankit Vyas, Hassaan Ali Ahmad, Tushar Tarun, Sourbha Dani, Javaria Ahmad, Corrine Zarwan and Sarju Ganatra have nothing to disclose. Ethical Approval: This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Figures

Fig. 1
Fig. 1
Management of atrial fibrillation in patients with breast cancer. AF = atrial fibrillation, DOAC = direct oral anticoagulant, LMWH = low molecular weight heparin, LAAO = left atrial appendage occlusion, DDI = drug–drug interaction, QTc = corrected QT interval, CHA2 DS2-VASc = Atrial Fibrillation Stroke Risk Score
Fig. 2
Fig. 2
Algorithm for managing atrial fibrillation in patients with breast cancer. AVJ = atrioventricular junction, PPM = permanent pacemaker, Ca = calcium, DOAC = direct oral anticoagulant, LMWH = low molecular weight heparin, LAAO = left atrial appendage occlusion, DDI = drug–drug interaction, CHA2 DS2-VASc = Atrial Fibrillation Stroke Risk Score
See this image and copyright information in PMC

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