Risk factors for the development of atrial fibrillation on ibrutinib treatment

Robert Lentz, Joseph Feinglass, Shuo Ma, Nausheen Akhter*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Ibrutinib increases the risk of atrial fibrillation (AF), but the associated risk factors are not clearly defined. We performed retrospective review of ibrutinib-treated patients in a large academic practice to identify risk factors for new-onset AF. Variables with p-values <.05 in logrank analysis were included as pairs in two-variable Cox regression. Of the 168 patients treated with ibrutinib, 60.7% had chronic lymphocytic leukemia/small lymphocytic lymphoma and 39.3% other histologies. The incidence of AF was 11.9% after a median 154-day ibrutinib exposure. Only heart failure (hazard ratio, 95% confidence interval; 14.1, 5.3–37.2) and left atrial abnormality on electrocardiogram (5.4, 1.9–15.4) were independently significant in paired Cox regression. Eighty-seven percent of patients with HF satisfied Framingham clinical criteria. As structural heart disease is a strong risk factor for incident AF, we emphasize the importance of baseline electrocardiogram, recommend baseline clinical screening for HF and, in specific instances, a baseline echocardiogram.

Original languageEnglish (US)
Pages (from-to)1447-1453
Number of pages7
JournalLeukemia and Lymphoma
Issue number6
StatePublished - May 12 2019


  • Atrial fibrillation
  • Bruton’s tyrosine kinase inhibitor
  • cardio-oncology
  • heart failure
  • ibrutinib
  • left atrial abnormality

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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