Acute myeloid leukemia electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shyam Patel [2]; Grammar Reviewer: Natalie Harpenau, B.S.[3]


Electrocardiogram is useful for assessment of QT interval prior to starting treatment with ivosidenib and arsenic trioxide. It is also useful for assessing arrhythmias induced by anthracycline chemotherapy.


The indications for electrocardiogram in acute myeloid leukemia include the following:

  • Assessment of QT interval:
    • Arsenic trioxide and ivosidenib are know to cause QT prolongation.
    • An electrocardiogram should be assessed at baseline prior to the start of these therapies.
    • The risk of QT prolongation with ivosidenib is 8%, per the phase 1 dose-escalation and dose-expansion study for this agent.[1]
    • Electrocardiograms should be obtained every 3 months while on therapy.
    • If the QT interval is greater than 500 milliseconds, the therapy should be discontinued.
  • Assessment of arrhythmias:
    • Anthracyclines such as idarubicin or doxorubicin can result in arrhythmias soon after infusion.
    • Arrhythmias are a rare but known complication of anthracycline.
    • Electrocardiogram is diagnostic of the specific type of arrhythmia.[2]


  1. Stein EM, DiNardo CD, Pollyea DA, Fathi AT, Roboz GJ, Altman JK; et al. (2017). "Enasidenib in mutant IDH2 relapsed or refractory acute myeloid leukemia". Blood. 130 (6): 722–731. doi:10.1182/blood-2017-04-779405. PMC 5572791. PMID 28588020.
  2. Hefti E, Blanco JG (2016). "Anthracycline-Related Cardiotoxicity in Patients with Acute Myeloid Leukemia and Down Syndrome: A Literature Review". Cardiovasc Toxicol. 16 (1): 5–13. doi:10.1007/s12012-015-9307-1. PMC 4514565. PMID 25616318.


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