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Case Reports
. 2013;40(5):626-7.

Transient, high-grade atrioventricular block from high-dose cyclophosphamide

Nayan Agarwal  1 , Thomas A Burkart  1
Affiliations
Case Reports

Transient, high-grade atrioventricular block from high-dose cyclophosphamide

Nayan Agarwal et al. Tex Heart Inst J. 2013.

Abstract

Cyclophosphamide, an alkylation agent, is widely used in stem cell transplantation for its antineoplastic and myeloablative properties. Congestive heart failure, pericarditis, and arrhythmias are well-known cardiac sequelae of high-dose cyclophosphamide therapy; however, high-grade atrioventricular block has rarely been reported. We present the case of a 71-year-old man who developed a high degree of atrioventricular block several hours after therapy with high-dose cyclophosphamide. After treatment with a temporary pacemaker and cessation of cyclophosphamide, the patient experienced no more events. Before administering cyclophosphamide, evaluating patients for underlying conduction abnormalities is advisable. Agents other than cyclophosphamide are available.

Keywords: Cyclophosphamide/administration & dosage/adverse effects; heart block/chemically induced/diagnosis/etiology; heart conduction system/drug effects; heart/drug effects; treatment outcome.

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Figures

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Fig. 1 Telemetry strip shows transient, high-grade atrioventricular block with asystolic pause.
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Fig. 2 Electrocardiogram reveals first-degree atrioventricular block but no bundle branch block.
See this image and copyright information in PMC

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