ATRIOVENTRICULAR-BLOCK FOLLOWED BY RADIATION-INDUCED PERICARDITIS 14 AND 17 YEARS AFTER HODGKINS-DISEASE

The as yet unreported occurrence of atrioventricular block followed by radiation-induced pericarditis after mediastinal irradiation for Hodgkin's disease in a 37-year-old female is described. Severe atrioventricular conduction disorders are uncommon (17 cases) and delayed (mean 14 years) after irradiation. Electrophysiologic studies disclose an block distal to the bundle of His in 6 cases out of seven. Outcome is favorable after implantation of a pacemaker. Radiation-induced pericarditis is now being reported after increasingly long time intervals. Constrictive pericarditis is often the outcome and may develop several decades after the radiation treatment. Periodic, prolonged cardiovascular monitoring is therefore warranted in patients with a history of mediastinal irradiation.