Electrocardiographic characteristics of Nigerian children on anthracycline-based chemotherapy: A preliminary report

Abstract

Background and Objective: Cardiotoxicity is one of the dose-limiting toxicities of anthracycline antibiotics, and electrophysiological abnormalities have been established. However, the existence of the established electrocardiographic abnormalities in pediatric cancer patients on chemotherapy is yet to be reported in Nigeria. This research seeks to characterize anthracycline cardiotoxicity in Nigerian children using electrocardiogram (ECG). Materials and Methods: Seventeen children on anthracycline-based regimen for various malignancies in the Paediatric oncology ward of Aminu Kano Teaching Hospital Kano, Nigeria, were recruited for this cross-sectional study. Those with normal serum electrolytes had a bedside ECG after obtaining informed consent. Their QTc, QTc-dispersion, and ST segment morphology were studied and compared with reference ranges of apparently normal Nigerian children where applicable. Results: There were 12 males (70.6%) and 5 females (29.4%) studied. The age range of the subjects was 2–7 years. Of the 17 subjects, only 3 were on daunorubicin-based regimen, while the rest were on doxorubicin-based regimen. The corrected QT was prolonged in 23.5% of the subjects; the QTc dispersion ranged from 20 to 126 for chest leads and 20–200 for limb leads. Whereas elevation of ST segment occurred in only one patient accounting for 5.9%, ST segment elevation, ST segment depression was present in 6 patients. Conclusion: There are remarkable differences in the ECG characteristics of patients in this report who had anthracyclines when compared to apparently healthy children.

Keywords

• Anthracycline
• cardiotoxicity
• daunorubicin
• doxorubicin
• electrocardiography