Recurrent Bradycardia Episodes Induced by Cisplatin Infusion

Chemotherapy may induce entire spectrum of cardiac pathology. Cisplatin has been used in oncology practice for a long time, but no sufficient clinical evidence exists about arrhythmogenic potential of this drug. We report a rarely diagnosed case of asymptomatic bradycardia probably induced by cisplatin infusion. In December 2010, a 28 years of woman was diagnosed with Sertoli-Leydig cell tumor. Three courses of BEP (bleomycine, etoposide, and cisplatin) chemotherapy was planned because of the poor prognostic factors. During the third course of chemotherapy, she had bradycardia during cisplatin infusion on routine vital sign assesments. Her physical examination including blood pressure was within normal limits. Electrocardiogram (ECG) revealed sinus bradycardia (40 beats/min). The patient had no clinical symptoms consistent with vagal stimulation. Blood pressure remained normal during and after the bradycardia episode. Concomitant serum concentrations of urea, creatinine, and electrolites (sodium, potassium, calcium, chloride, and magnesium) were within normal ranges. Her chemotherapy was terminated and 24-hour holter ECG was performed to reveal the bradycardia episodes. She had asyptomatic bradycardia during the records of holter ECG. After a few days of follow up her bradycardia episodes resolved. It was worthwile for this case presentation because the patient presented with asymptomatic bradycardia after cisplatin infusion. Cisplatin-induced sinus bradycardia is an unusual adverse effect with underlying mechanisms that remain to be clarified.