Elevation of the pacing threshold: A side effect in a patient with pacemaker undergoing therapy with doxorubicin and vincristine

A 56-year-old female patient with an IgG plasmocytoma first diagnosed 5 yea rs before underwent 3 cycles of chemotherapy according to the VAD scheme, A WI pacemaker had been implanted 3 years earlier. After each cycle, the out put of the pacemaker had to be increased as the pacing threshold had increa sed, resulting in a slow pulse, This case demonstrates that patients with a pacemaker that undergo chemotherapy with cardiotoxic agents must be follow ed carefully.