Checkpoint Immunotherapy-Induced Myocarditis and Encephalitis Complicated With Complete AV Block

Lorente-Ros, Álvaro; Rajjoub-Al-Mahdi, Ez-Alddin; Ruiz, Juan Manuel Monteagudo; García, Sonia Rivas; Pérez, Rodrigo Ortega; Golfin, C Fernandez; Álvarez‐García, Jesús; Gómez, José Luis Zamorano

doi:10.1016/j.jaccas.2022.04.020

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…Of significant interest for the role of advanced imaging is the occurrence of acute ICI induced myocarditis, whose incidence is documented around 0.04–1.14% and which has been associated with a worsening of mortality. 24,25 Clinical features are extremely variable, in terms of disease onset and severity of manifestations, ranging from fatal myocarditis to transient myocardial edema. Median interval time from first treatment to disease presentation is typically 1–2 months, but cases of delayed onset have been reported up to one year.…”

Section: Cardiotoxicity Manifestations and Mechanismsmentioning

confidence: 99%

Multimodality imaging in cardio-oncology: the added value of CMR and CCTA

Lisi

Catapano

Rondi

et al. 2023

The British Journal of Radiology

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During the last 30 years, we have assisted to a great implementation in anticancer treatment with a subsequent increase of cancer survivors and decreased mortality. This has led to an ongoing interest about the possible therapy-related side-effects and their management to better guide patients therapy and surveillance in the chronic and long-term setting. As a consequence cardio-oncology was born, involving several different specialties, among which radiology plays a relevant role. Till the end of August 2022, when European Society of Cardiology (ESC) developed the first guidelines on cardio-oncology, no general indications existed to guide diagnosis and treatment of cancer therapy-related cardiovascular toxicity (CTR-CVT). They defined multimodality imaging role in primary and secondary prevention strategies, cancer treatment surveillance and early CTR-CVT identification and management. Cardiac computed tomography angiography (CCTA) has acquired a central role in coronary assessment, as far as coronary artery disease (CAD) exclusion is concerned; but on the side of this well-known application, it also started to be considered in left ventricular function evaluation, interstitial fibrosis quantification and cardiac perfusion studies. Cardiac magnetic resonance (CMR), instead, has been acknowledged as the gold standard alternative to trans-thoracic echocardiography (TTE) poor acoustic window in quantification of heart function and strain modifications, as well as pre- and post-contrast tissue characterization by means of T1-T2 mapping, early Gadolinium enhancement (EGE), late Gadolinium enhancement (LGE) and extracellular volume (ECV) evaluation. Our review is intended to provide a focus on the actual role of CMR and CCTA in the setting of a better understanding of cardiotoxicity and to draw some possible future directions of cardiac imaging in this field, starting from the recently published ESC guidelines.

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Section: Cardiotoxicity Manifestations and Mechanismsmentioning

confidence: 99%

Multimodality imaging in cardio-oncology: the added value of CMR and CCTA

Lisi

Catapano

Rondi

et al. 2023

The British Journal of Radiology

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“…Permanent pacing is indicated in patients with complete atrioventricular block (AVB) or advanced AVB ( 3 ). Several previous cases have reported the possibility to recover from ICIs-associated complete AVB, and the duration from heart block onset to recovery was highly various from days to months ( 4 – 7 ). On one hand, temporary transvenous passive pacing lead is unstable and might cause procedure-related complications such as electrode displacement, thrombotic events and immobilization when left in place for long duration ( 8 – 10 ).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Temporary pacing using active fixation lead and invasive electrophysiology studies for immune checkpoint inhibitor associated reversible advanced atrioventricular block

Wang,

Qian,

Jin

et al. 2024

Front. Cardiovasc. Med.

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A case of immune checkpoint inhibitors (ICIs)-associated myocarditis with reversible advanced atrioventricular block (AVB) was reported. We innovatively used active fixation lead connected to an external device for prolonged temporary pacing until atrioventricular conduction recovered. Invasive electrophysiology studies were performed to evaluate atrioventricular conduction in detail. Long-term follow-up for nearly 120-days and repeated long-term electrocardiography was conducted to ensure the conduction system was truly recovered.

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Ipilimumab/nivolumab

2022

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Checkpoint Immunotherapy-Induced Myocarditis and Encephalitis Complicated With Complete AV Block

Cited by 7 publications

References 10 publications

Multimodality imaging in cardio-oncology: the added value of CMR and CCTA

Multimodality imaging in cardio-oncology: the added value of CMR and CCTA

Case Report: Temporary pacing using active fixation lead and invasive electrophysiology studies for immune checkpoint inhibitor associated reversible advanced atrioventricular block

Ipilimumab/nivolumab

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