A case of irreversible bradycardia after rituximab therapy for diffuse large B-cell lymphoma

Ko, Nway L. Ko; Minaskeian, Nareg; Masry, Hicham El

doi:10.1186/s40959-020-00077-5

Cited by 5 publications

(3 citation statements)

References 9 publications

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“… 20 Two case reports of CHB have been published, but one of the patients had previous conduction disease, and the other was an aged patient; hence the causality is difficult to ascertain. 21 22 It was postulated that rituximab might affect the cardiac conduction system by inhibiting Ca 2+ channel properties of the CD20 antigen on cardiac myocytes. 22 …”

Section: Case 1: Bradycardia With Antithymocyte Globulinmentioning

confidence: 99%

Bradyarrhythmias in Cardio-Oncology

Fonseca

Cheng

et al. 2021

South Asian J Cancer

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The relationship between bradyarrhythmias and cancer therapies has not been well described but is increasingly recognized. There have been extensive advances in oncological pharmacotherapy, with several new classes of drugs available including targeted agents, immune checkpoint inhibitors and CAR T cell therapy. This increasing repertoire of available drugs has revolutionized overall prognosis and survival of cancer patients but the true extent of their cardiovascular toxicity is only beginning to be understood. Previous studies and published reviews have traditionally focused on conventional chemotherapies and in arrhythmias in general, particularly tachyarrhythmias. The number of patients with both cancer and cardiovascular problems is increasing globally and oncologists and cardiologists need to be adept at managing arrythmia based scenarios. Greater collaboration between the two specialties including studies with prospective data collection in Cardio-Oncology are much needed to fill in knowledge gaps in this arena. This case-based review summarizes current available evidence of cancer treatment-related bradyarrhythmia incidence (including its different subtypes), possible mechanisms and outcomes. Furthermore, we propose a stepwise surveillance and management protocol for patients with suspected bradyarrhythmia related to cancer treatment.

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Section: Case 1: Bradycardia With Antithymocyte Globulinmentioning

confidence: 99%

Bradyarrhythmias in Cardio-Oncology

Fonseca

Cheng

et al. 2021

South Asian J Cancer

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“…One review has presented evidence that the incidence of supraventricular tachycardia was higher in the group received rituximab in addition to standard cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy vs CHOP therapy alone. 5 There are cases of other non–ventricular tachycardia (VT)-related events which appear to affect all parts of the heart (conduction, structural, coronary circulation) including irreversible bradycardia, 6 non-ischemic cardiomyopathy, 7 coronary vasospasm, 8 and coronary artery occlusion and associated ST-elevation myocardial infarction. 9 …”

Section: Introductionmentioning

confidence: 99%

An Unusual Case of Delayed-Onset Rituximab-Induced Ventricular Tachycardia: A Case Report

Arabyan,

Hambartzhumian,

Lim

et al. 2024

Journal of Investigative Medicine High Impact Case Reports

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Cardiac disease associated with cancer treatment is a common adverse effect that is well-treated with appropriate monitoring. However, some cardiac adverse effects with cancer treatment are not well-understood, in particular rituximab-associated ventricular tachycardia. We present the fourth case of rituximab-associated ventricular tachycardia in a patient who is rituximab-naive and who does not have known cardiac disease history. This patient developed non-sustained polymorphic ventricular tachycardia 14 hours after rituximab was started and 6 hours after it was stopped, and after extensive monitoring including a 30-day event monitor, did not develop further significant runs of ventricular tachycardia.

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“…Bradycardia has rarely been reported with rituximab, both in patients with normal and abnormal conduction systems. 1 It is presumed to occur due to impairment of CD20 antigen, which functions as a calcium ion channel. 2 Although our patient had multiple risk factors for bradycardia such as the use of diltiazem, metoprolol, moxonidine, and subclinical hypothyroidism, yet he had a consistently normal HR, and symptomatic bradycardia only occurred after rituximab infusion.…”

mentioning

confidence: 99%

Symptomatic Bradycardia Post Rituximab Infusion

Jaryal,

Sidhu,

Vikrant

2023

Indian Journal of Nephrology

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A case of irreversible bradycardia after rituximab therapy for diffuse large B-cell lymphoma

Cited by 5 publications

References 9 publications

Bradyarrhythmias in Cardio-Oncology

Bradyarrhythmias in Cardio-Oncology

An Unusual Case of Delayed-Onset Rituximab-Induced Ventricular Tachycardia: A Case Report

Symptomatic Bradycardia Post Rituximab Infusion

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