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Case Reports in Oncological Medicine
Volume 2017, Article ID 7304021, 3 pages
https://doi.org/10.1155/2017/7304021
Case Report

Profound Sinoatrial Arrest Associated with Ibrutinib

1Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
2Department of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, VA, USA

Correspondence should be addressed to Kanupriya Mathur; moc.liamg@504ayirpunak

Received 9 August 2017; Accepted 13 November 2017; Published 10 December 2017

Academic Editor: Josep M. Ribera

Copyright © 2017 Kanupriya Mathur et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Ibrutinib is a Bruton’s tyrosine kinase (BTK) inhibitor approved for second-line treatment for mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and Waldenström macroglobulinemia. Ibrutinib use has been linked to increased incidence of atrial fibrillation and hypertension in multiple studies. Other forms of cardiac toxicities have also been reported in isolated case reports. Bradycardia and asystole have not been associated with ibrutinib use in the past. Case Report. We present a case of a 76-year-old female with no prior cardiac history, who initiated treatment with ibrutinib for relapsing mantle cell lymphoma and was noted to have symptomatic bradycardia, greater than 20 second long pauses on her cardiac monitor requiring placement of a permanent pacemaker. Conclusion. This is the first case associating bradycardia and asystole with tyrosine kinase inhibitor use. Irreversible inhibition of certain cardioprotective tyrosine kinases has been a growing topic of research in oncology therapeutics.