Why the study?
Cardiotoxicity is an important side effect of vascular endothelial growth factor inhibitor therapy, but bevacizumab-associated arrhythmia had not been previously reported.
This case report highlights the potential risk of ventricular arrhythmia as an adverse effect of bevacizumab therapy in cancer patients.
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Bevacizumab may induce ventricular arrhythmia and ECG changes; this case report leaves open the need for prospective cardiotoxicity surveillance in VEGF inhibitor therapy.
RATIONALE: Cardiotoxicity is an important side effect of vascular endothelial growth factor inhibitors therapy in the treatment of cancer. Massive studies have shown bevacizumab-related hypertension, venous, and arterial thrombosis. PATIENT CONCERNS: A 56-year-old female patient was treated with bevacizumab monotherapy for lung adenocarcinoma. The patient was detected a poor R-wave increase with slight ST segment elevation in V1-V3 leads, and ventricular arrhythmia. DIAGNOSIS: The incidental arrhythmia caused by bevacizumab was considered. INTERVENTIONS: The patients received aspirin and amiodarone (0.2 g tid) to treat arrhythmia. After consultation with the cardiology department, the patient received a diagnostic coronary angiography. Coronary angiography showed 30% of the right coronary artery stenoses and no obvious organic stenosis in the left main artery, left anterior ascending, or left circumflex. OUTCOMES: The patient exhibited disappearance of chest tightness and rapid heartbeat after the treatment of amiodarone. Electrocardiogram monitoring results returning to normal. LESSONS: This is the first reported case of bevacizumab-associated arrhythmia. It is advisable to consider the risk of arrhythmia in bevacizumab monotherapy or combines treatment.
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Li et al. (2023) studied this question.
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