pirarubicin and Atrial-Fibrillation

Primary cardiac lymphoma (PCL) only rarely occurs and it is defined as a lymphoma in which the bulk of the tumor is located within the heart and pericardium. A 53-year-old woman was referred due to dyspnea, and an electrocardiogram exhibited atrial fibrillation (AF). Echocardiography revealed no abnormal findings. Scintigraphy and a lymph node biopsy led to a diagnosis of PCL. After the start of chemotherapy, AF was converted to atrial tachycardia prior to sinus rhythm with a first-degree atrioventricular block, which was finally restored to a normal sinus rhythm. PCL is only rarely encountered, but it should be included in the differential diagnosis as a possible cause of AF, and such AF could be reversible if the patient can be treated in a timely manner.

Topics: Antineoplastic Combined Chemotherapy Protocols; Atrial Fibrillation; Atrioventricular Block; Bradycardia; Cyclophosphamide; Doxorubicin; Dyspnea; Echocardiography; Female; Heart Neoplasms; Humans; Lymphoma, B-Cell; Middle Aged; Prednisolone; Radionuclide Imaging; Rituximab; Tomography, X-Ray Computed; Treatment Outcome; Vincristine

To investigate the detailed acute cardiotoxicity of the anthracycline antibiotics, adriamycin (ADM) and a tetrahydropyranyl derivative (THP-ADM), Holter ECG was recorded and some of the electrocardiographic parameters were analyzed. The basic rhythm was sinus rhythm in many cases except only one case which developed intermittent atrial fibrillation after the administration of ADM. No effect on the specialized conduction system was observed in either ADM or TH-PADM. In relation to the supraventricular premature beat, no increase of the pre-existing supraventricular extrasystole and fresh appearance of the supraventricular extrasystole were observed after the administration of these drugs. On the other hand, the ventricular premature beat was tended to increase after ADM administration, and the mode of appearance of the ventricular extrasystole was very dangerous and life-threatening. For example, short-run type and R on T type ventricular extrasystole were recorded. THP-ADM induced no significant increase of the ventricular extrasystole. The developed ST-T changes were seen after the administration of these drugs, but the patients complained neither the symptoms of heart failure nor stenocardia. In conclusion. THP-ADM had less cardiotoxicity than ADM.

Topics: Adolescent; Adult; Aged; Arrhythmias, Cardiac; Atrial Fibrillation; Breast Neoplasms; Cardiac Complexes, Premature; Doxorubicin; Electrocardiography; Female; Heart; Humans; Lung Neoplasms; Lymphoma; Male; Middle Aged; Neoplasms