title: Transient, high-grade atrioventricular block from high-dose cyclophosphamide.
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.
authors.affiliation: Department of Cardiovascular Medicine, UF Health Shands Hospital, Gainesville, Florida 32608.
authors.forename: Nayan
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Department of Cardiovascular Medicine, UF Health Shands Hospital, Gainesville, Florida 32608.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Burkart
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D054537:Atrioventricular Block / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy*; D013686:Telemetry
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide
keywords: Cyclophosphamide/administration & dosage/adverse effects; heart block/chemically induced/diagnosis/etiology; heart conduction system/drug effects; heart/drug effects; treatment outcome