Atrial Fibrillation in the Oncology Patient

Interview With Kamala Tamirisa, MD

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Interview by Jodie Elrod

Watch as Kamala Tamirisa, MD, from Texas Cardiac Arrhythmia Institute, discusses her presentation at Western AF 2025.

Tell us about your presentation at the Western AFib Symposium 2025. 

Hi, I am Kamala Tamirisa, one of the cardiac electrophysiologists with Texas Cardiac Arrhythmia in Dallas, Texas. I'm super excited to be at the Western Atrial Fibrillation (AFib) Symposium in Salt Lake City. This is one of my favorite conferences for many reasons, and we'll cover that in a bit. 

My talk here is on AFib in cancer patients. Why should I as an EP doctor worry about cancer? Well, electrophysiology as a field is expanding to cover multiple different fields, and it's spanning across heart failure, pregnancies, and cancer as well. Just a few key facts: AFib risk is 47% higher in people with cancer than those without cancer. The risk of stroke and bleeding risk is higher as well. Based on the limited trials and the data we have, the outcomes including cardiovascular mortality and overall mortality is higher if a patient had AFib with cancer. Obviously, not all cancers have the same risk of AFib, and that's what I'm going to cover tomorrow. 

What would be some take-home points to help our patients with cancer and AFib? Right now, if we look at the risk score for stroke, we use the CHA₂DS₂-VASc risk score. Unfortunately, cancer is not one of them. Should we be changing the paradigm? Cancer increases the risk of stroke. Maybe it's time to think of the future. 

The second thing is we do not have longitudinal data or large clinical trials. Maybe we should look at high-risk anti-cancer therapy like kinase inhibitors and see if we need to do longitudinal studies to look at AFib burden and outcomes. The third one is should we be monitoring our patients with cancer with implantable loop recorders to gather the burden of the disease? So, these are some questions for the future. Obviously, AI is going to change the paradigm more as we do precision medicine and individualize and customize treatment and management.

So, that's my topic tomorrow. I’m super excited to share my thoughts on it and engage the audience. 

The transcripts were edited for clarity and length.