Bevacizumab-induced arrhythmia in a patient with lung adenocarcinoma: A case report

RATIONALE: Cardiotoxicity is an important side effect of vascular endothelial growth factor inhibitors therapy in the treatment of cancer. Massive studies have shown bevacizumab-related hypertension, venous, and arterial thrombosis. PATIENT CONCERNS: A 56-year-old female patient was treated with bevacizumab monotherapy for lung adenocarcinoma. The patient was detected a poor R-wave increase with slight ST segment elevation in V1–V3 leads, and ventricular arrhythmia. DIAGNOSIS: The incidental arrhythmia caused by bevacizumab was considered. INTERVENTIONS: The patients received aspirin and amiodarone (0.2 g tid) to treat arrhythmia. After consultation with the cardiology department, the patient received a diagnostic coronary angiography. Coronary angiography showed 30% of the right coronary artery stenoses and no obvious organic stenosis in the left main artery, left anterior ascending, or left circumflex. OUTCOMES: The patient exhibited disappearance of chest tightness and rapid heartbeat after the treatment of amiodarone. Electrocardiogram monitoring results returning to normal. LESSONS: This is the first reported case of bevacizumab-associated arrhythmia. It is advisable to consider the risk of arrhythmia in bevacizumab monotherapy or combines treatment.