Docetaxel-Associated Paroxysmal Atrial Fibrillation in a Patient Receiving Docetaxel Plus Cyclophosphamide (TC) Therapy

Abstract

Objective: To report a case of paroxysmal atrial fibrillation in a patient who was receiving a chemotherapy regimen including docetaxel plus cyclophosphamide (TC). Case Report: A 67-year-old woman was receiving TC therapy for stage IIB breast cancer. She developed symptomatic paroxysmal atrial fibrillation following chemotherapy administration. The patient presented with tachycardia-palpitations, a shaking sensation inside her body, shortness of breath, and tightness in her chest that did not radiate. Propafenone treatment was replaced with sotalol. Cycle 2 of chemotherapy was administered and symptoms of atrial fibrillation returned. Sotalol was switched to dronedarone monotherapy and the symptoms resolved. Discussion: Based on the Naranjo probability scale, chemotherapy was the probable cause of the patient's episodes of paroxysmal atrial fibrillation. Conclusions: As single agents, taxanes have minimal cardiac toxicity, although cardiac toxicity may be higher with precipitating factors. Clinicians caring for patients receiving taxane chemotherapy should be aware of the potential for docetaxel-induced paroxysmal atrial fibrillation.