Sisplatin İnfüzyonuna Bağlı Tekrarlayan Bradikardi Atakları

Devrim  Çabuk; Mustafa Volkan  Demir; Selçuk  Yaylacı; Mehmet Bülent  Vatan; Ali  Tamer

doi:10.5505/sakaryamj.2013.09609

Recurrent Bradycardia Episodes Induced by Cisplatin Infusion

Year 2013, Volume: 3 Issue: 4, 218 - 220, 01.12.2013

Devrim Çabuk Mustafa Volkan Demir Selçuk Yaylacı Mehmet Bülent Vatan Ali Tamer

https://doi.org/10.5505/sakaryamj.2013.09609

Cited By: 1

Abstract

Chemotherapy may induce entire spectrum of cardiac pathology. Cisplatin has been used in oncology practice for a long time, but no sufficient clinical evidence exists about arrhythmogenic potential of this drug. We report a rarely diagnosed case of asymptomatic bradycardia probably induced by cisplatin infusion. In December 2010, a 28 years of woman was diagnosed with Sertoli-Leydig cell tumor. Three courses of BEP (bleomycine, etoposide, and cisplatin) chemotherapy was planned because of the poor prognostic factors. During the third course of chemotherapy, she had bradycardia during cisplatin infusion on routine vital sign assesments. Her physical examination including blood pressure was within normal limits. Electrocardiogram (ECG) revealed sinus bradycardia (40 beats/min). The patient had no clinical symptoms consistent with vagal stimulation. Blood pressure remained normal during and after the bradycardia episode. Concomitant serum concentrations of urea, creatinine, and electrolites (sodium, potassium, calcium, chloride, and magnesium) were within normal ranges. Her chemotherapy was terminated and 24-hour holter ECG was performed to reveal the bradycardia episodes. She had asyptomatic bradycardia during the records of holter ECG. After a few days of follow up her bradycardia episodes resolved. It was worthwile for this case presentation because the patient presented with asymptomatic bradycardia after cisplatin infusion. Cisplatin-induced sinus bradycardia is an unusual adverse effect with underlying mechanisms that remain to be clarified.

Keywords

Chemotherapy, cisplatin, bradycardia

References

Hochster H, Wasserheit C, Speyer J. Cardiotoxicity and cardioprotection during chemotherapy. Curr Opin Oncol 1995; 7: 304-9.
Allen A. The cardiotoxicity of chemotherapeutic drugs. Semin Oncol 1992; 18 (5): 529-42.
Brestescher C, Pautier P, Farge D. Chemotherapy and cardiotoxicity. Ann Cardiol Angiol 1995; 44 (8): 443-8.
Loehrer PJ, Einhorn LH. Cisplatin. Ann Intern Med 1984; 100:704- 13
Eskilsson J, Albertsson M, Mercke C. Adverse cardiac effects during induction chemotherapy treatment with cisplatin and 5-fluorouracil. Radiother Oncol 1988;13:41-6.
Hashimi LA, Khalyl MF, Salem PA. Supraventricular tachycardia, a probable complication of platinum treatment. Oncology 1984; 41:174-5.
Tassinari D, Sartori S, Drudi G, et al. Cardiac arrhythmias after cisplatin infusion: three case reports and a review of literature. Ann Oncol 1997;8:1263-7.
Schlaeffer F, Tovi F, Leiberman A. Cisplatin induced bradycardia. Drug Intel Clin Pharmacol 1983;17:899-900.
Menard O, Martinet Y, Lamy P. Cisplatin induced atrial fibrillation. J Clin Oncol 1991;9:192-3.
Altundag O, Celik I, Kars A. Recurrent asymptomatic bradycardia episodes after cisplatin infusion. Ann Pharmacother 2001;35:641- 2.
Zumkley H, Bertram HP, Preusser P et al. Renal excretion of magnesium and trace elements during cisplatin treatment. Clin Nephrol 1982; 17: 254-7.
Blachley JD, Hill JB. Renal and electrolyte disturbances associated with cisplatin. Ann Intern Med. 1981; 95:628-32.
Sartori S, Nielsen I, Tassinari D, Rigolin F, Arcudi D, Abbasciano V. Changes in intracellular magnesium concentrations during cisplatin chemotherapy. Oncology. 1993;50:230-4.