Yonsei Med J.  2011 Jan;52(1):196-198. 10.3349/ymj.2011.52.1.196.

Complete Atrioventricular Block Secondary to Bortezomib Use in Multiple Myeloma

  • 1Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea. kdhmd@inha.ac.kr


Bortezomib is an inhibitor of 26S proteasome, which is an effective treatment for multiple myeloma. The common adverse effects of bortezomib are asthenic conditions, gastrointestinal disturbances, and peripheral neuropathy. Here we describe a patient with dyspnea and general weakness because of complete atrioventricular block while receiving bortezomib. We immediately stopped bortezomib, and after inserting a permanent VDD pacemaker, the patients' symptoms disappeared.


Bortezomib; multiple myeloma; adverse effect; atrioventricular block

MeSH Terms

Atrioventricular Block/*chemically induced
Boronic Acids/*adverse effects/*therapeutic use
Middle Aged
Multiple Myeloma/*drug therapy
Pyrazines/*adverse effects/*therapeutic use


  • Fig. 1 Chest X-ray at admission. The chest X-ray is normal with a slight cardiomegaly.

  • Fig. 2 (A) A 12-lead electrocardiogram of the patient before using bortezomib. No specific ST or T abnormalities, with normal sinus rhythm. (B) A 12-lead electrocardiogram of the patient at admission. More P waves than the QRS complexes and dissociation with P waves and QRS complexes, which stands for complete atrioventricular block.

  • Fig. 3 (A) Chest X-ray after pacemaker insertion. The pacemaker lead is shown at the apex of right ventricle in the X-ray (arrow), which indicates successful pacemaker insertion. (B) A 12-lead electrocardiogram after insertion of pacemaker. The electrocardiogram shows successful pacing of the pacemaker.


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