Skip to main content
. Author manuscript; available in PMC: 2017 May 3.
Published in final edited form as: N Engl J Med. 2016 Nov 3;375(18):1749–1755. doi: 10.1056/NEJMoa1609214

Figure 1.

Figure 1

Electrocardiographic and immune effects on cardiac muscle following ipilimumab and nivolumab treatment. Patient 1’s ECG rapidly progressed to complete heart block (Panel A) followed by ventricular tachycardia (Panel B). Autopsy demonstrated lymphocytic infiltration in myocardium (intraventricular septum pictured, Panel C). Inflammatory infiltrate was comprised of CD3 positive T lymphocytes (Panel D), many of which were positive for CD8 (Panel E). Only cardiac and skeletal muscle were affected; smooth muscle and other tissue were spared (Panel F). The black arrow denotes esophageal smooth muscle without immune infiltration and the green arrow denotes esophageal skeletal muscle, which is heavily infiltrated by immune cells.