5-fluorouracil (5-FU) and other antimetabolites can affect a patient's ECG during and after chemotherapy.
Possible mechanism: vasospasm
ECG changes may include:
(1) ischemic changes (elevated ST waves, peaked T waves, Q waves)
(2) QTc prolongation with or without Torsade des Pointes
(3) sinus bradycardia
(4) atrial fibrillation
(5) ventricular tachycardia or fibrillation
Risk factors for ECG changes:
(1) high dose of the antimetabolite
(2) continuous infusion
(3) history of ischemic heart disease
(4) concurrent therapy with other drugs affecting the ECG
(5) older adult
(6) renal failure
(7) prior mediastinal irradiation
(8) hypomagnesemia
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Specialty: Hematology Oncology, Cardiology, Pharmacology, clinical
