Radiation therapy for malignant thymoma can rarely cause complete atrioventricular block, likely due to radiation-induced occlusive changes in the small arteries supplying the conduction system.
May cause late complete AV block via microvascular occlusion after thymoma radiation; hypothesis-generating for conduction-system monitoring strategies.
Complete atrioventricular block following radiation is very rare. We present a case which developed after radiation therapy for malignant thymoma. The etiology of conduction disturbances due to radiation is unknown. In our case, serial electrocardiograms showed stepwise progression of the conduction disturbance, and His bundle electrocardiograms revealed new prolongation of the H-V interval. Endomyocardial biopsy specimens demonstrated occlusion in small arteries and diffuse degenerative changes in the myocardium. We therefore attributed the complete atrioventricular block in our patient to secondary damage to the conduction system, caused by radiation-induced occlusive changes in the small arteries supplying the conduction system.
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Nakao et al. (1990) studied this question.
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