Atrial fibrillation following treatment with paclitaxel: A case report

Abstract

Paclitaxel (PTX) is an antimicrotubule agent, and is effective in treating a wide range of solid tumors. However, its use may lead to cardiovascular toxicities, the manifestations of which include arrhythmia, heart failure, acute myocardial ischemia and atrial fibrillation (AF). AF is among the severe reactions to the PTX cardiotoxicity, and a cause for substantial morbidity and mortality. However, the incidence of PTX-induced AF is reportedly low (1.0-1.7% worldwide), and few cases have been reported in the literature. Thus, to emphasize the need for awareness of this side effect of PTX among clinicians, the report herein presents a case of AF induced by PTX in a patient with non-small-cell carcinoma. A 51-year-old man experienced AF following treatment with PTX. Amiodarone and metoprolol were administered to the patient to control cardiac rhythm and rate. After 3 days, the electrocardiogram was normalized and indicated normal heart rate and rhythm. According to this case, thorough attention should be paid during PTX treatment to monitor for signs of AF or other abnormalities in cardiac function.

Keywords: atrial fibrillation; cardiovascular toxicities; non-small-cell carcinoma; paclitaxel.

Figure 1.

Electrocardiogram prior to adjuvant chemotherapy with paclitaxel and cisplatin.

Figure 2.

Electrocardiogram following adjuvant chemotherapy with paclitaxel and cisplatin.

Figure 3.

Electrocardiogram following administration of amiodarone and metoprolol.

Figure 4.

Schematic illustration of the mechanisms of atrial fibrillation (AF) induced by paclitaxel (PTX).