5-Fluorouracil increases the number and complexity of premature complexes in the heart: a prospective study using ambulatory ECG monitoring
- 10 April 2007
- journal article
- Published by Hindawi Limited in International Journal of Clinical Practice
- Vol. 61 (5), 795-801
- https://doi.org/10.1111/j.1742-1241.2007.01323.x
Abstract
The cardiac toxicity of LV5FU2 (de Gramont) regimen which is a widely used chemotherapy regimen in gastrointestinal system cancers is not well defined. We aimed to evaluate the impact of this regimen on cardiac rhythm. Two Holter ECG recordings were obtained in all patients with gastrointestinal system cancers treated with LV5FU2 regimen as first-line chemotherapy (one before and the second during the first 24 h of chemotherapy). Records were reviewed for the heart rate, rhythm, atrial premature complexes (APC), ventricular premature complexes (VPC), grades according to Lown-Wolf grading system and ST segment changes. Holter ECG recordings were evaluated in 27 patients. In the baseline evaluation, neither clinical symptom nor ST segment changes were observed. During the treatment period, chest pain was observed in two patients without any cardiac enzyme and ST segment changes. Moreover, a decrease in mean heart rate, and an increase in the number and complexity of premature complexes secondary to treatment were observed. The mean heart rate, APC per hour and VPC per hour (+/-SD) before vs. during treatment were, respectively, 93.1+/-16.4 vs. 81.6+/-12.7 (p=0.001), 18.9+/-54.0 vs. 45.3+/-53.8 vs. (p=0.049) and 12.7+/-29.6 vs. 38.1+/-42.1 (p=0.002). LV5FU2 regimen leads to a decrease in mean heart rate and a significant increase in APC and VPC which may lead to serious arrhythmias. These effects must be better understood for a safer administration of this useful and widely used drug regimen.Keywords
This publication has 26 references indexed in Scilit:
- Evaluation of Cardiotoxicity of a Combined Bolus plus Infusional 5-Fluorouracil/Folinic Acid Treatment by Echocardiography, Plasma Troponin I Level, QT Interval and Dispersion in Patients with Gastrointestinal System CancersJapanese Journal of Clinical Oncology, 2004
- Drug-Induced Prolongation of the QT IntervalThe New England Journal of Medicine, 2004
- Electrocardiographic and Cardiovascular Effects of the 5-Hydroxytryptamine3Receptor AntagonistsAnnals of Pharmacotherapy, 2003
- Randomized trial comparing monthly low-dose leucovorin and fluorouracil bolus with bimonthly high-dose leucovorin and fluorouracil bolus plus continuous infusion for advanced colorectal cancer: a French intergroup study.Journal of Clinical Oncology, 1997
- Cardiotoxicity of 5-fluorouracil in combination with folinic acid in patients with gastrointestinal cancerCancer, 1993
- Symptomatic Cardiotoxicity with High-Dose 5-Fluorouracil Infusion: A Prospective StudyOncology, 1993
- Cardiotoxicity of high-dose continuous infusion fluorouracil: a prospective clinical study.Journal of Clinical Oncology, 1992
- Continuous ambulatory ECG monitoring during fluorouracil therapy: a prospective study.Journal of Clinical Oncology, 1989
- A prospective randomized comparison of continuous infusion fluorouracil with a conventional bolus schedule in metastatic colorectal carcinoma: a Mid-Atlantic Oncology Program Study.Journal of Clinical Oncology, 1989
- Approaches to Sudden Death from Coronary Heart DiseaseCirculation, 1971