[Sick sinus syndrome in a patient with myeloma-associated amyloidosis]

A 62-year-old woman was admitted with general malaise and anorexia in September, 1988. Multiple myeloma (IgA-lambda, Stage IIIb) was diagnosed, and amyloidosis was also diagnosed by abdominal fat aspiration biopsy. A partial remission was achieved by MEVP combination chemotherapy, and she was discharged in December, 1988. She was readmitted because of dizziness and palpitation in April, 1989. A diagnosis of sick sinus syndrome was made, and a VVI permanent pacemaker (PPM) was implanted. She was able to walk to our outpatient clinic for 10 months after the PPM implantation. However, right hemiplegia and aphasia were recognized on April 19, 1990. CT scans revealed low density in the areas of the left anterior and middle cerebral artery. The symptoms of congestive heart failure worsened progressively, and the patient, who had been confined to bed, died on March 5, 1991. She was the fifth myeloma-associated amyloidosis patient who received a PPM implantation. Her survival time was one year and ten months, and was the longest among a small number of reported cases with PPM implantation.