Supraventricular arrhythmia: A complication of 5-fluorouracil therapy

Aziz, Sheikh Aejaz; Tramboo, Nisar A.; Mohiuddin, Khalid; Iqbal, Khurshid; Jalal, S.; Ahmad, Mehtab

doi:10.1016/s0936-6555(98)80033-2

Cited by 26 publications

(13 citation statements)

References 4 publications

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“…One thousand three hundred and seventeen patients were consecutively admitted with a first diagnosis of breast or colorectal cancer (case group). In order to avoid confounding factors due to the well-known association between major surgery [10,11], chemotherapy [12] and AF, all patients included did not have previous cancer treatments. The remaining 1,022 subjects were patients admitted to the Surgery Department of our hospital to undergo non-neoplastic surgeries (control group).…”

Section: Study Populationmentioning

confidence: 99%

First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

et al. 2008

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Aim of the present study was to assess the prevalence of atrial fibrillation (AF) in patients with two different types of cancer. Recent epidemiologic and clinical studies support the hypothesis that AF is promoted and maintained by a broad spectrum of modulating factors. A total of 2,339 patients admitted to the Surgery Department of "Luigi Sacco Hospital, Milan," over the period 1987-2004 were eligible for the study. One thousand three hundred and seventeen patients were admitted consecutively with a first diagnosis of colorectal or breast cancer (cases). The remaining 1,022 were patients admitted to undergo non-neoplastic surgery (controls). Routine pre-surgery electrocardiogram available in patient charts was analysed by a cardiologist who was not aware of the present study to evaluate the presence of atrial fibrillation or other arrhythmias. Overall, AF was present in 3.6% cases and 1.6% controls. This corresponded to at least two times higher likelihood of having AF in cases compared to controls. Prevalence of AF increased with age both in cases and controls. Our study describes an increased prevalence of AF in two different types of cancer. Autonomic, endocrine, coagulation, and inflammatory alterations were previously described in both AF and cancer, and can provide the physiopathological basis to our clinical observation.

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Section: Study Populationmentioning

confidence: 99%

First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

et al. 2008

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“…This occurrence of sinus bradycardia is not often reported in literature and needs to be kept in mind while assessing cardiotoxicity of 5-FU. 10 The incidence of 5FU related sinus bradycardia in our study was 8% (n = 2). These patients had prolonged sinus nodal functions and AH interval.…”

Section: Discussionmentioning

confidence: 42%

“…One of the rare cardiotoxic event in that study was sinus bradycardia. 10 We also noticed that 5-Fluorouracil induced bradycardia may be due to hypervagotonia? As vagolytics abolished it.…”

Section: Discussionmentioning

confidence: 96%

“…9 We observed some electrocardiographic changes in-patients receiving 5-FU based chemotherapy viz sinus bradycardia, atria fibrillation etc. 10 Though not exotic, these arrhythmias had been described in world literature on 5-FU cardio toxicity. However, case reports and personal communications about similar arrhythmias resonated in the years to follow.We also found that 5-FU bradycardia might be a hypervagotonia as vagolytics would abolish it.…”

Section: Introductionmentioning

confidence: 94%

“…[6][7][8][9] 5 Fluorouracil induced cardiotoxicity is more frequent during first cycle. 10 Continuous intravenous infusion is reported to be more likely to cause cardiac events which are more probably due to increased intravenous volume administered . 9 We observed some electrocardiographic changes in-patients receiving 5-FU based chemotherapy viz sinus bradycardia, atria fibrillation etc.…”

Section: Introductionmentioning

confidence: 99%

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Effect of 5-fluorouracil on sinoatrial node and conduction system of heart

et al. 2017

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Background: 5-FU a cytostatic agent is used to treat various malignancies. Cardiotoxicity is infrequent complication of 5-FU. Previously we had observed ECG changes in our patients on 5-FU viz sinus bradycardia, atrial fibrillation. We also found that 5-FU bradycardia might be a hypervagotonia as vagolytics abolished it. This study was undertaken to assess the impact of this commonly used chemotherapeutic agent on basic physiologic parameters of impulse initiation and conduction in human heart. The aim was to study effect of 5-FU on electrophysiological properties of SA node and conduction system of heart.Methods: Pre -5 FU state patients were subjected to electrophysiological study and following parameters were checked viz heart rate, CSNRT. SACT, AH and HV intervals and wenckebach point. Post 5- FU state these parameters were again checked. Response to Atropine was seen in patients who developed sinus bradycardia.Results: Sinus bradycardia was seen in 8% (n=2) of patients in post 5FUstate Their electrophysiological parameters SNRT, CSNRT, SACT, AH were mildly prolonged (above the normal) in post 5FU state. Post atropine there was increase in heart rate and the deranged electrophysiological parameters came back to normal. Atrial fibrillation was seen in two patients while performing sinus nodal functions in post 5FU state.Conclusions: Sinus bradycardia is a rare cardiotoxic side effect of 5FU, is a result of an autonomic imbalance viz hypervagotonia which is abolished by atropine and more common in infusuion form than bolus. Infra-his conduction is not altererd and threshold for inducing atrial arrhythmias is decreased in post 5-FU state.

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Cardiovascular Toxicity of Antitumor Drugs: Dimensions of the Problem in Children

Scully¹,

Lipshultz²

2010

Cardiotoxicity of Non‐Cardiovascular Drugs

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Supraventricular arrhythmia: A complication of 5-fluorouracil therapy

Cited by 26 publications

References 4 publications

First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

First diagnosis of colorectal or breast cancer and prevalence of atrial fibrillation

Effect of 5-fluorouracil on sinoatrial node and conduction system of heart

Cardiovascular Toxicity of Antitumor Drugs: Dimensions of the Problem in Children

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