Secondary Cardiac Lymphoma Presenting as Sick Sinus Syndrome and Atrial Fibrillation Which Required Leadless Pacemaker Implantation

Intern Med. 2021 Feb 1;60(3):431-434. doi: 10.2169/internalmedicine.5573-20. Epub 2020 Sep 19.

Abstract

Cardiac involvement of malignant lymphoma is relatively common, although such a phenomenon has subclinical manifestations that are difficult to detect. We herein describe a patient with atrial fibrillation and sick sinus syndrome as the main symptoms. Computed tomography showed a mass in the right atrium extending into the superior vena cava (SVC). We implanted the patient with a leadless pacemaker. Transvenous biopsy revealed a diffuse large B-cell lymphoma. The patient was treated successfully with chemotherapy including rituximab. This case suggested that cardiac lymphoma may cause sick sinus syndrome, and leadless pacemaker implantation is a safe treatment option in patients with partial SVC obstruction.

Keywords: atrial fibrillation; cardiac lymphoma; leadless pacemaker; sick sinus syndrome.

MeSH terms

  • Atrial Fibrillation* / therapy
  • Humans
  • Lymphoma* / complications
  • Lymphoma* / diagnosis
  • Lymphoma* / therapy
  • Pacemaker, Artificial*
  • Sick Sinus Syndrome / complications
  • Sick Sinus Syndrome / diagnosis
  • Sick Sinus Syndrome / therapy
  • Vena Cava, Superior