活动性癌症与房颤（AF）的风险增加有关，这取决于预先存在的基质（尤其是在老年患者中），癌症类型和阶段以及正在接受的抗癌治疗。迄今为止，研究尚未能够确定每个因素的个体贡献。在抗癌药物治疗期间，根据多种因素，包括患者的基线心血管毒性风险和使用的AF检测策略，AF可能发生的频率约为15-20％。许多抗癌药物已与AF或AF报告有关，包括发生和复发的AF，但缺乏强有力的数据。只有布鲁顿酪氨酸激酶抑制剂与AF相关（主要是伊布替尼），具有大约3-4倍的AF风险高水平证据。患有活动性癌症的AF患者与全身性血栓栓塞或中风的风险增加两倍，必须使用“TBIP”（血栓栓塞风险，出血风险，药物相互作用，患者偏好）结构化方法来评估抗凝治疗的需要。患有活动性癌症的AF患者还与六倍心力衰竭的风险增加有关，并且必须针对最佳症状控制，通常使用速率控制药物（β受体阻滞剂），但对于仍有症状的患者，可能会提出节律控制策略。 AF通常是可管理的，包括伊布替尼在内的抗癌药物的继续;尽可能避免中断癌症药物，并权衡癌症进展的风险。版权所有©2023 Elsevier Masson SAS出版。

Active cancer is associated with an increased risk of atrial fibrillation (AF), which varies depending on the pre-existing substrate (particularly in older patients), the cancer type and stage, and the anticancer therapeutics being taken. To date, studies have not been able to identify the individual contribution of each factor. During anticancer drug therapy, AF may occur with a frequency of ≈ 15-20% according to several factors, including the patient's baseline cardiovascular toxicity risk and the AF-detection strategies used. Many anticancer drugs have been associated with AF or AF reporting, both in terms of incident and recurrent AF, but robust data are lacking. Only bruton tyrosine kinase inhibitor associated AF (mainly ibrutinib) has a high level of evidence, with a ≈ 3-4-fold higher risk of AF. AF in patients with active cancer is associated with a twofold higher risk of systemic thromboembolism or stroke, and the "TBIP" (Thromboembolic risk, Bleeding risk, drug-drug Interactions, Patient preferences) structured approach must be used to evaluate the need for anticoagulation therapy. AF in patients with active cancer is also associated with a sixfold higher risk of heart failure, and optimal symptom control must be targeted, usually with rate-control drugs (beta-blockers), but a rhythm-control strategy may be proposed in patients remaining symptomatic despite optimal rate-control. AF is generally manageable, with the continuation of anticancer drugs (including ibrutinib); interruption of cancer drugs must be avoided whenever possible and weighed against the risk of cancer progression.Copyright © 2023. Published by Elsevier Masson SAS.