SHM Converge Scientific Abstract ePoster Gallery-Third Degree Heart Block: Rare Side Effect of Dasatinib

Pdf Summary

This case report describes a 65-year-old woman with chronic myeloid leukemia (CML) and peripheral arterial disease who developed dizziness and bradycardia after a recent switch from clopidogrel to ticagrelor. Her ECG showed complete, third-degree atrioventricular (AV) block. She was also taking dasatinib, a second-generation tyrosine kinase inhibitor used to treat Philadelphia chromosome–positive CML.<br /><br />During hospitalization, both dasatinib and ticagrelor were held. She was supported with a dopamine infusion and ultimately required permanent pacemaker placement. After cardiology evaluation, she was transitioned back to clopidogrel for her PAD and later restarted on dasatinib 80 mg.<br /><br />The report emphasizes that dasatinib can rarely cause serious cardiac arrhythmias, including third-degree AV block, likely due to its effects on kinases beyond BCR-ABL. Ticagrelor is also associated with bradyarrhythmias, though these are usually transient and rarely progress to high-grade block. In this case, the patient had been on dasatinib for months before the event, while ticagrelor had only been started three days earlier, making dasatinib the most likely primary cause, with ticagrelor possibly contributing to risk.<br /><br />The key message is that clinicians should recognize the potential for severe conduction abnormalities with dasatinib, especially when combined with other agents that may affect heart rate or AV conduction. Prompt identification and management, including drug discontinuation, hemodynamic support, and pacemaker placement when needed, are essential.

Asset Subtitle

Mumta Essarani

Meta Tag

Author List Ashley Paul, Melony Mody, Mumta Essarani

Category Clinical Vignettes

Concept Dasatinib

Concept Complete Heart Block

Concept Cardiac Arrhythmia

Concept Bradycardia

Concept Heart block

Distinguished Non-Finalist

Presenter Organization Bayhealth Medical Center

Presenting Author Mumta Essarani

Track Adult

Keywords

chronic myeloid leukemia

dasatinib

ticagrelor

third-degree atrioventricular block

bradycardia

complete heart block

pacemaker placement

tyrosine kinase inhibitor

peripheral arterial disease

cardiac arrhythmia

Dasatinib

Complete Heart Block

Cardiac Arrhythmia

Bradycardia

Heart block