Arrhythmias and Conduction Disorders in HSCT

Cardiac complications, particularly arrhythmias and conduction disorders, present significant challenges in the management of patients undergoing hematopoietic stem-cell transplantationHematopoietic Stem Cell Transplantation (HSCT) (HSCT). Despite the relatively low incidence of these complications, which is reported to be less than 10%, their impact on non-relapse mortality and quality of life is substantial. This study aimed to review the types, risk factors, mechanisms, diagnosis, and management of various arrhythmias seen in HSCT recipients. Supraventricular arrhythmias like atrial fibrillation and atrial flutter are the most common arrhythmias observed, occurring in 7–27% of patients. ChemotherapyChemotherapy drugs used for HSCT conditioning like anthracyclines, alkylating agents, and proteasome inhibitors have been shown to cause arrhythmias through various mechanisms. Factors like older age, pre-existing cardiovascular disease, mediastinal irradiation, graft-versus-host disease increase arrhythmia risk. Detailed evaluation including electrocardiography, ambulatory monitoring aids diagnosis. Management depends on arrhythmia type and involves rate or rhythm control, anticoagulation, drug dose reduction/change based on complications. Close collaboration between cardiologists and oncologists is needed for regular monitoring, prevention, and timely treatment of arrhythmias in HSCT patients given their impact on outcomes.