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sprycel/dasatanib and heart issues

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hello, i was diagnosed with CML in december 2018 and started dasatanib 100mg on december 26, 2018. i met all the milestones according to my oncologist and got to MRR in 2020. i joined this forum and received plenty of useful information for which i'm grateful. i also read a number of posts and research on this forum about 50mg of dasatanib being just as effective and probably more beneficial than the higher dose of 100mg. i showed my oncologist the printouts of research that was posted on this forum regarding lower dose of dasatanib and he reluctantly lowered my dose to 50mg. this was in 2021 and i have remained 'undetectable' since. i now have a new oncologist (my previous doctor moved away) and she is open to my lowering dose further to 20mg dasatanib.

however, recently i started to have frequent palpitations and high heart rate. an EKG was normal and an ultrasound was normal. my cardiologist also prescribed a heart monitor to be worn but after wearing the monitor for 10 days, the results showed AV block with frequent occurrences. i fear this is from the dasatanib. i was not thinking that i would ever want to try treatment free remission but this heart issue is making me very concerned and i am going to talk to my oncologist about TFR in April when i see her. she told me to take a break from dasatanib while the cardiologist is figuring out what to do, and i've been completely off it for about 3 weeks now. i'm still feeling the palpitations and fluttering. has anyone else experienced this? if this heart condition is caused by dasatanib i wonder how long one would have to be off it before the palpitations would perhaps stop or at least not be as often. thanks to anyone who reads this, any input or sharing of experiences is appreciated. my EKG's and other tests every year have all been normal until now...

update, was told by cardio yesterday that i will need a pacemaker for this condition

Could this be a non TKI-related issue? Not sure of your age but a lot of things can be a factor. I was under the impression that Nilotinib could potentially affect the heart, not Dasatinib.

Not the same issue as yours, but I had to come off dasatinib 4 years after starting it because I developed lymph node swelling. Two in my neck were the size of a golf ball. Upon stopping dasatinib, they returned to normal size within less than a week. However, I also had to come off imatinib due to side effects and it took over a year for my joint pain and muscle pain disappeared. So I guess the side effects can persist for a while. I hope you get to the bottom of what's causing the paliptations!

Here's an article that studies potential cardiotoxicity caused by TKIs:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3222244/