High Dose Cytosine Arabinoside- Induced Asymptomatic Bradycardia

Abstract

Cytosine Arabinoside (Cytarabine) is commonly used agents in acute myeloid leukemia (AML). Cardiovascular side effects are not common during treatment. We aimed to present asymptomatic bradycardia developed during the first consolidation treatment in a patient with acute myeloid leukemia. A 34-year-old male patient was diagnosed with AML in February. After induction chemotherapy, high dose cytarabine treatment was started at 2x1.5 grams/m² for consolidation treatment. On the 11th day of the treatment, his pulse decreased to 39 beats/min. On the 12th day after the initiation of high dose cytosine arabinoside treatment (6 days after chemotherapy treatment ends), the patient's pulse rate was above 50/min, and there was no bradycardia in the following days. Other causes of other causes of bradycardia were excluded. It was reported that the patient had sinus bradycardia with an ejection fraction of 65% and his heart rate was rhythmic. There are seven patients with acute myeloid leukemia, one patient with acute lymphoblastic leukemia, one patient with non-Hodgkin's lymphoma, and one patient with Hodgkin's lymphoma who reported high dose cytosine arabinoside associated bradycardia. In addition, one patient with acute myeloid leukemia developed bradycardia with low dose cytosine arabinoside. Our case is the 11th case in the literature that develops bradycardia due to cytarabine.