Electrocardiographic changes following adriamycin treatment.

Two hundred and fifty-six patients with a wide variety of advanced neoplasms who were treated with adriamycin at Roswell Park Memorial Institute were studied for electrocardiographic changes. All the patients had pre- and posttreatment electrocardiograms (ECG's) and changes were found in 85 (33.2%). In the group of 1-8 patients with normal pretreatment ECG's, changes occurred in 51 (30.3%). In the group of 88 patients who had abnormal pretreatment ECG's, 34 (38.6%) developed further changes following treatment. Twenty-five patients received cytoxan concomitantly and ECG changes developed in 12 (48%); however, this and the above difference were not statistically significant. Frequency of ECG changes was higher and the extent of histologic abnormality in the myocardium was greater in those patients who received high doses of adriamycin. Arrythmias were rather benign and only a small number of patients required treatment. ECG changes following adriamycin treatment occurred more frequently than previously reported.