Table 3.
Case reports with ICI-associated arrhythmia.
| Study | Patient Characteristics | CV Side Effect | Symptoms | Diagnosis | Pre-Existent CVD | ICI | Type of Cancer | Arrhythmias Onset | Concomitant Treatments | Arrhythmias Treatment | Evolution | Concomitant AID |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Joseph, 2021 | ♂, 78 | AF | not mentioned | ECG | hypertension | PD-1i | metastatic melanoma | 35 weeks | not mentioned | TEE-guided cardioversion | favorable | not mentioned |
| ♂, 68 | AF | not mentioned | ECG | hypertension | PD-1i | metastatic melanoma | 14 weeks | not mentioned | self-limited AF (48 h) | favorable | not mentioned | |
| ♂, 66 | AF | not mentioned | ECG | hypertension | PD-1i | metastatic melanoma | 2 weeks | not mentioned | beta-blockers | favorable | hyperthyroidism | |
| ♂, 74 | sinus bradycardia, AF with RVR |
fatigue and dizziness |
ECG | 3 ablations for AF | PD-1i | metastatic melanoma | 21 weeks | not mentioned | beta-blockers | favorable | not mentioned | |
| Reddy, 2017 | ♂, 68 | sinus tachycardia, 1st degree AVB, RBBB, LAFB followed bycomplete AVB) | fatigue, generalized malaise, weakness with ambulation NYHA IIB symptoms | ECG, Tn, CK-MB, echocardiogram, cardiac catheterization | not mentioned | PD-1i + CTLA-4i | metastatic sarcoma | 2 weeks | not mentioned | high-dose IV steroids, temporary transvenous pacemaker, MMF | favorable | not mentioned |
| Giancaterino, 2020 | ♂, 88 | ECGs–progression normal SR + with PAC- 3rd AVB (hospital day 5) |
generalized weakness | ECG, Tn, CK-MB, TTE | not mentioned | invasive melanoma | first - 22 days prior |
prednisone 40 mg daily nivolumab infusions were held IV methylprednisolone Infliximab dual-chamber pacemaker—day 10 |
decline clinically- VF- fatal | myositis | ||
| Behling, 2017 | ♂, 63 | complete AVB (44 bpm) | worsening of a pre-existing dyspnea | ECG, echocardiogram, cardiac catheterization, myoglobin, Tn | hypertension | PD-1i | metastatic melanoma | 3 weeks | not mentioned | temporary pacemaker, corticosteroids, oxygen therapy | fatal | not mentioned |
| Katsume, 2018 | ♂, 73 | complete AVB (wide QRS complexes) | fatigue, faintness, syncope, palpitations | ECG, echocardiogram, cardiac catheterization, TnT, CK | not mentioned | PD-1i | metastatic NSCLC | 2 weeks | not mentioned | IV steroids, pacemaker (temporary permanent) | favorable | not mentioned |
| Hsu, 2018 | ♂, 42 | sinus bradycardia (40 bpm) | fatigue, dizziness, anorexia, hypotension | ECG, TnI | not mentioned | PD-1i | metastatic liver cancer | not mentioned | not mentioned | PO steroids | favorable | not mentioned |
| Pohl, 2020 | ♀, 61 | new 1st degree AVB, QTc prolongation | not mentioned | ECG, echocardiogram | not mentioned | PD-1i | metastatic melanoma | 4–12 weeks | not mentioned | not mentioned | not mentioned | not mentioned |
| Khan, 2020 | ♀, 67 | Mobitz type 2 2nd degree AVB (30 bpm) complete AVB (22 bpm) after 3 h | asymptomatic | ECG, echocardiogram, TnT | hypertension, hyperlipidemia | PD-1i | metastatic NSCLC | 3 weeks | not mentioned | dobutamine, pacemaker (temporary permanent) | favorable | not mentioned |
Abbreviations: AF, atrial fibrillation; AVB, atrioventricular block; CK, creatine kinase; CK-MB, creatine kinase–muscle/brain; CTLA-4i, cytotoxic T-lymphocyte-associated protein 4 inhibitor; ECG, electrocardiography; IV, intravenous; LAFB, left anterior fascicular block; MMF, mycophenolate mofetil; NSCLC, non-small cell lung cancer; NYHA, New York Heart Association; PO, per oral; PD-1i, programmed cell death 1 inhibitor; RBBB, right bundle branch block; RVR, rapid ventricular response; TEE, transesophageal echocardiogram; Tn, troponin.