BACKGROUND: Cardiovascular (CV) adverse events (AEs), especially atrial fibrillation (AF) and hypertension, have been reported in patients receiving treatments for chronic lymphocytic leukemia (CLL), including Bruton's tyrosine kinase inhibitors (BTKis). Although these AEs are managed effectively in most cases and AE management guidelines exist, practical management approaches are inconsistent across regions and practices. We aimed to address these inconsistencies by developing consensus recommendations. SUMMARY: A European expert panel was assembled comprising eight hematologists and six cardiologists. Literature analysis, expert interviews, and the Delphi method were used to gain consensus on screening, monitoring, and treatment of AF and hypertension statements. KEY MESSAGES: Maintaining BTKi treatment is paramount to maximize time to next treatment; for patients at high risk of progression, this can be achieved by appropriately treating hypertension and AF and adjusting the BTKi dose. Patients should be risk-stratified as low, moderate, high, or very-high risk of cancer therapy-related CV toxicity and treated according to their disease status so that CLL treatment can be maintained. Patient education on symptom monitoring, home blood pressure monitoring, and electrocardiograms (baseline, every 3 months) are recommended to detect/monitor AF and hypertension. Close collaboration between hematologists and cardiologists is vital to achieve optimal patient outcomes.

Cardiac Amyloidosis Reference Center and Expert Center for Hereditary Transthyretin Amyloidosis University Hospital St Ivan Rilski Sofia Bulgaria

Cardiology and Angiology Center Vilnius University Hospital Vilnius Lithuania

Cardiology Center University Hospital J A Reiman Prešov Slovakia

Department of Cardiology UMC Ljubljana Ljubljana Slovenia

Department of Haematology Leeds Teaching Hospitals NHS Trust Leeds UK

Department of Haematology UMC Ljubljana Ljubljana Slovenia; Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Department of Hematology University Hospital Dubrava Zagreb Croatia

Department of Hematology Vilnius University Hospital Vilnius Lithuania

Department of Internal Medicine and Haematology Semmelweis University Budapest Hungary

Department of Internal Medicine Hematology and Oncology University Hospital and Masaryk University Brno Czechia

Department of Medicine Albert Szent Györgyi Medical School University of Szeged and Department of Transfusion Medicine Albert Szent Györgyi Medical School University of Szeged Szeged Hungary

Department of Oncohematology Comenius University and National Cancer Institute Bratislava Slovakia

Division of Hematology Medical University of Plovdiv Plovdiv Bulgaria

University Hospital Centre Sisters of Mercy Zagreb Croatia

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