{"doi":"10.1038/s41375-024-02334-3","title":"Atrial fibrillation burden and clinical outcomes following BTK inhibitor initiation","abstract":"Bruton's tyrosine kinase inhibitors (BTKi) have dramatic efficacy against B-cell malignancies, but link with cardiotoxicity, including atrial fibrillation (AF). Burden, severity, and implications of BTKi-related AF are unknown. Leveraging a large-cohort of consecutive B-cell malignancy patients initiated on BTKi from 2009-2020, we identified patients with extended ambulatory rhythm monitoring. The primary outcome was AF burden after BTKi-initiation. Secondary outcomes included ventricular arrhythmia burden and other arrhythmias. Observed incident-AF rates and burden with next-generation BTKi's were compared to ibrutinib. Multivariable regression defined association between rhythm measures and major adverse cardiac events (MACE), and mortality. There were 98 BTKi-treated patients [38.8% next-generation BTKi's, 14.3% prior-AF], with 28,224 h of monitoring. Median duration BTKi-use was 34 months. Over mean duration 12 days monitoring, 72.4% developed arrhythmias (16.3% incident-AF, 31.6% other SVTs, 14.3% ventricular tachycardia). 14.3% had high AF-burden. AF-burden was similar between ibrutinib and next-generation BTKi's. No single antiarrhythmic-therapy prevented BTKi-related AF. However, antiarrhythmic initiation associated with reduction in arrhythmic burden (P = 0.009). In a multivariable model accounting for traditional cardiovascular risk factors, prior-AF associated with increased post-BTKi AF-burden. In follow-up, high AF burden associated with MACE (HR 3.12, P = 0.005) and mortality (HR 2.97, P = 0.007). Among BTKi-treated patients, high AF burden prognosticates future MACE and mortality risk.","journal":"Leukemia","year":2024,"id":431736,"datarank":0.4335557636844247,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.0,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9635,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1019403,"name":"Sanam Ghazi","orcid":"0000-0002-7205-1427","position":1,"is_corresponding":false},{"id":1030954,"name":"Stephen Sansoterra","orcid":"0000-0002-8453-387X","position":2,"is_corresponding":false},{"id":1020332,"name":"Mussammat Ferdousi","orcid":null,"position":3,"is_corresponding":false},{"id":792196,"name":"Onaopepo Kola‐Kehinde","orcid":"0000-0001-9270-0415","position":4,"is_corresponding":false},{"id":792642,"name":"Patrick Ruz","orcid":null,"position":5,"is_corresponding":false},{"id":767147,"name":"Adam S. Kittai","orcid":"0000-0002-4891-6144","position":6,"is_corresponding":false},{"id":278927,"name":"Kerry A. Rogers","orcid":"0000-0001-5748-7874","position":7,"is_corresponding":false},{"id":35685,"name":"Michael R. Grever","orcid":"0000-0002-1605-7875","position":8,"is_corresponding":false},{"id":278932,"name":"Seema A. Bhat","orcid":"0000-0001-7844-0856","position":9,"is_corresponding":false},{"id":511859,"name":"Tracy Wiczer","orcid":null,"position":10,"is_corresponding":false},{"id":511547,"name":"John C. Byrd","orcid":"0000-0002-8778-1000","position":11,"is_corresponding":false},{"id":245731,"name":"Jennifer A. Woyach","orcid":"0000-0002-3403-9144","position":12,"is_corresponding":false},{"id":430239,"name":"Daniel Addison","orcid":"0000-0002-9113-8333","position":13,"is_corresponding":false},{"id":882463,"name":"John Alan Gambril","orcid":"0000-0001-9797-5979","position":0,"is_corresponding":true}],"reference_count":36,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:59:30.747263Z","pmid":"39154059","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}