Cardioneuroablation in a young patient with sinus node dysfunction secondary to cardiotoxicity in diffuse large B-cell lymphoma

Anthracyclines (e.g., doxorubicin) and vinca alkaloids included in the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) remain therapeutic mainstays for DLBCL, but are associated with cardiovascular toxicity ranging from ventricular dysfunction to arrhythmias and conduction disturbances (1,2). The incidence of arrhythmias in hospitalized patients with DLBCL is approximately 11% and increases with age and cumulative chemotherapy exposure (3). Pathogenic mechanisms include oxidative stress, mitochondrial injury, and fibrosis of the conduction system.