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BTK inhibitors
(e.g., ibrutinib, acalabrutinib, zalubrutinib)

Cardio-oncological evaluation*

before cancer treatment begins

Cardio-oncological evaluation* AND home blood pressure monitoring

every 3 months for 1 year, then every 6 months during all ibrutinib therapy

Asymptomatic

Continue cardio-oncological follow-up* **

Symptomatic

Holter-ECG monitoring in addition to cardio-oncological follow-up*

* A cardio-oncological evaluation will systematically include at least one visit with blood pressure, blood glucose, lipid profile, GFR calculation, ECG and trans-thoracic echocardiography (TTE). Measurements of global longitudinal strain and 3D LVEF (if feasible) are recommended with the same machine.

** Holter-ECG monitoring can be considered even in asymptomatic patients to asymptomatic atrial fibrillation or ventricular arrhythmia.

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