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Non-Hodgkins lymphoma survivor diagnosed with mediastinal mass in chest x-ray. Had radiation. Afib developed. Due to cancer treatment?


My name is Diana and I am a non-hodgkins lymphoma survivor. My GP discovered the stage two medistinal
Mass on a chest x ray August 2006. My oncologist gave me 8 rounds of RCHOP and one month of low dose radiation to the front and back of the chest. I was given a MUGA scan before and after treatment. Fall two years ago my heart was out of rhythm it was afib. My cardiologist did a TEE and cardioversion on me. My heart went out rhythm two and a half days latter. He was going to cardiovert me again but flecainide put me in rhythm. After one full year on flecainide 50 mg twice daily my cardiologist decided to completely take me off of flecainide. He said if my heart got out of rhythm take 100 mg of flecainide. He wants me to try the "pill in pocket" approach. Well, today after one whole week off the flecainide I went out of rhythm. Do you believe the chemo and radiation was the likely cause of my afib? Do you think I will need to stay on a regular dose of flecainide to maintain rhythm? I don't like the uncertainty of living without a regular dose. What do you think the purpose was to take me off the flecainide? Is it the possible long term side effects?

Thank you in advance for your advice.

Diana :)

Asked On : Fri, 26 Apr 2013
Answers:  1 Views:  85
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Oncologist 's  Response
Dear gnassios,
The chemotherapy which you have undergone contains one drug called anthracycline. This drug beyond a certain cumulative dose is known to cause some cardiac effects. Rituximab and chest radiation have the potentiating effect. So every possiblity of post chemo radio effect leading to arrythmia.
Taking flecainide continously is not harmful. The purpose that your cardiologist wanted to stop this medicine was to see if you can do without it. Since the arrythmia recured you can continue to use the drug. There will be no long term side effects.
Dr. J. Ticku
Answered: Fri, 26 Apr 2013
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