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Case report
Irinotecan inducing sinus pause bradycardia in a patient with small round cell cancer
  1. Tanveer Ahmad Mir1,
  2. Ahmed S Yassin1,
  3. Eric Joseph Denha1,
  4. Raad Al Shaikhli1,
  5. Ali Rahim1,
  6. Sabah Ambreen2 and
  7. Prateek Lohia1
  1. 1Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan, USA
  2. 2Independent Researcher, Detroit, MI, USA
  1. Correspondence to Dr Tanveer Ahmad Mir; gr6723{at}


Irinotecan is a novel anticancer drug that has worked wonders in combination with other anticancer drugs. It can be used as a single chemotherapy agent in colonic cancer treatment or in combination with 5-fluorouracil. Irinotecan has been found a better salvage therapy in patients who are resistant to 5-fluorouracil. It is also used in combination with cisplatin and other drugs for cancers such as pleural mesothelioma, Ewing’s sarcoma, lung cancer and others, and has helped reduce tumour burden. Irinotecan is generally associated with gastrointestinal side effects including nausea, vomiting and diarrhoea, while cardiovascular toxicity (5%) has been reported mainly as vasodilatation and possible bradycardia with no known incidence. A case was reported in 1998 by Miya et al of a 65-year-old man with bradycardia which was managed with atropine without modifications in the dosage of irinotecan or in the rate of infusion. We report a case of a patient with small round cell cancer who presented with sinus pause bradycardia after infusion with irinotecan. The patient was managed with atropine during chemotherapy.

  • cardiovascular medicine
  • arrhythmias
  • haematology (drugs and medicines)
  • malignant disease and immunosuppression

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  • Contributors TAM, ASY, EJD, RAS, AR, SA and PL: compiling the data, case review, and formatting and final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.