Recurrent cytarabine-induced sinus bradycardia in a patient with acute myeloid leukemia: a case report and review of the literature

Cytarabine-induced sinus bradycardia is a rare but clinically significant adverse event that may occur even in patients without pre-existing cardiac disease or traditional cardiotoxic risk factors. This case is unique for its delayed onset, recurrence upon rechallenge, and transient decline in left ventricular ejection fraction. Clinicians should maintain vigilance for bradyarrhythmias during both induction and consolidation phases of cytarabine therapy, even at lower doses. Awareness of this phenomenon allows timely recognition, avoidance of unnecessary treatment discontinuation, and safe continuation of potentially curative therapy under appropriate cardiac monitoring.