Very delayed sinus arrest during complete remission of diffuse large B-cell lymphoma invading right atrium [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(5): 414-418 | DOI: 10.5543/tkda.2021.57474

Very delayed sinus arrest during complete remission of diffuse large B-cell lymphoma invading right atrium

Toshimitsu Tsugu1, Yuji Nagatomo2, Emiko Matsuyama3, Patrizio Lancellotti1, Hideo Mitamura3
1Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
2Department of Cardiology, National Defense Medical College Hospital, Tokorozawa, Japan
3Department of Cardiology, Federation of National Public Service Personnel Mutual Aid Association Tachikawa, Hospital, Tachikawa, Japan

Diffuse large B-cell lymphoma (DLBCL)-associated arrhythmias may be due to cardiac involvement or may be chemotherapy-induced. There have been no reports of significant arrhythmias with normal cardiac function occurring during the complete remission of DLBCL. A 57-year-old female, who had had no history of abnormal electrocardiograms (ECGs) in annual medical checkups, was admitted to our hospital because of low-grade fever, night sweats, and weight loss. On admission, ECG revealed a variable rhythm consisting of sinus beats and occasional escape beats. Computed tomography and 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) revealed two masses in the right atrium (RA) and the uterus. Total hysterectomy was performed, and pathological findings were consistent with diffuse large B-cell lymphoma (DLBCL). Chemotherapy (R-CHOP) was initiated. After two chemotherapy cycles, RA tumors disappeared, and bradyarrhythmia simultaneously converted to sinus rhythm without antiarrhythmic drug therapy. Six months after completion of chemotherapy, FDG-PET/CT revealed negative uptake in the RA and the uterus. The patient attained complete remission of DLBCL, but ECG showed bradycardia because of sinus arrest. Our case suggests that DLBCL-induced arrhythmia can occur even after its remission and should be monitored.

Keywords: Doxorubicin, Cardiotoxicity, Cardiac tumor, Arrhythmia

How to cite this article
Toshimitsu Tsugu, Yuji Nagatomo, Emiko Matsuyama, Patrizio Lancellotti, Hideo Mitamura. Very delayed sinus arrest during complete remission of diffuse large B-cell lymphoma invading right atrium. Turk Kardiyol Dern Ars. 2021; 49(5): 414-418

Corresponding Author: Toshimitsu Tsugu, Belgium
© Copyright 2021 Archives of the Turkish Society of Cardiology
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