Atrial fibrillation (AF) is frequently observed in patients being treated for
cancer and can lead to increased morbidity and mortality in this population. With the use of newer, targeted
cancer therapies, several drug-drug interactions have emerged that complicate the use of
antiarrhythmic drugs (AADs) in patients with active
malignancy. Moreover, specific targeted
therapies such as
ibrutinib may contribute directly to the development of AF. The decision to pursue systemic anticoagulation can be challenging in patients with
malignancy due to a number of factors, including the need for frequent procedures, the presence of
malignancy-related risk factors for
bleeding, and limited data regarding the safety of the novel oral
anticoagulants (NOACs) in
cancer patients. This review describes the challenges associated with AF management in patients with
cancer and highlights a number of important drug-drug interactions that can impact patient management.