Intrapericardial bleomycin may lead to arrhythmia

Background: Malignant pericardial effusion can lead to cardiac tamponade. T he condition is treated with drainage often followed by intrapericardial in stillation of a sclerosing agent such as bleomycin. No major side effects l ike arrhythmia have been reported after intrapericardial instillation of bl eomycin, Case Report: We describe the case of clinically relevant, although transient atypical atrial flutter 6 hours after intrapericardial instillat ion of 30 mg of bleomycin in a patient with malignant effusion due to metas tatic breast cancer. The arrhythmia subsided after 12 hours and has not rec urred during the following 9 months. Conclusions: 30 mg of intrapericardial bleomycin may lead to atrial arrhythmia. Smaller doses of bleomycin have b een reported not to be arrhythmogenic and may be equally effective.