高剂量环磷酰胺导致的短暂性高度房室传导阻滞。
Transient, high-grade atrioventricular block from high-dose cyclophosphamide.
作者信息
Agarwal Nayan, Burkart Thomas A
机构信息
Department of Cardiovascular Medicine, UF Health Shands Hospital, Gainesville, Florida 32608.
出版信息
Tex Heart Inst J. 2013;40(5):626-7.
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.
环磷酰胺是一种烷化剂，因其抗肿瘤和骨髓清除特性而广泛应用于干细胞移植。充血性心力衰竭、心包炎和心律失常是高剂量环磷酰胺治疗众所周知的心脏后遗症；然而，高度房室传导阻滞鲜有报道。我们报告一例71岁男性患者，在接受高剂量环磷酰胺治疗数小时后发生高度房室传导阻滞。经临时起搏器治疗及停用环磷酰胺后，患者未再出现此类情况。在给予环磷酰胺之前，建议评估患者是否存在潜在的传导异常。也可选用环磷酰胺以外的药物。
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