Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram

<b>Background/Objectives</b>: Immune checkpoint inhibitor (ICI)-associated cardiovascular adverse events are relatively uncommon; they can be life-threatening, particularly when involving malignant ventricular arrhythmias. Electrocardiographic markers such as P-wave dispersion (PWD), QT...

Full description

Saved in:
Bibliographic Details
Main Authors: Alper Coskun, Ece Celebi Coskun, Ahmet Bilgehan Sahin, Fatih Levent, Eyup Coban, Fatih Koca, Seda Sali, Omer Furkan Demir, Adem Deligonul, Erhan Tenekecioglu, Erdem Cubukcu, Fahriye Vatansever Agca, Turkkan Evrensel
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/15/10/1235
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849327609482051584
author Alper Coskun
Ece Celebi Coskun
Ahmet Bilgehan Sahin
Fatih Levent
Eyup Coban
Fatih Koca
Seda Sali
Omer Furkan Demir
Adem Deligonul
Erhan Tenekecioglu
Erdem Cubukcu
Fahriye Vatansever Agca
Turkkan Evrensel
author_facet Alper Coskun
Ece Celebi Coskun
Ahmet Bilgehan Sahin
Fatih Levent
Eyup Coban
Fatih Koca
Seda Sali
Omer Furkan Demir
Adem Deligonul
Erhan Tenekecioglu
Erdem Cubukcu
Fahriye Vatansever Agca
Turkkan Evrensel
author_sort Alper Coskun
collection DOAJ
description <b>Background/Objectives</b>: Immune checkpoint inhibitor (ICI)-associated cardiovascular adverse events are relatively uncommon; they can be life-threatening, particularly when involving malignant ventricular arrhythmias. Electrocardiographic markers such as P-wave dispersion (PWD), QT dispersion (QTd), T-peak to T-end (Tp-e) interval, and Tp-e/QT and Tp-e/QTc ratios have been linked to an elevated risk of both atrial and ventricular arrhythmias and sudden cardiac death across various cardiac conditions. Monitoring these parameters may aid in identifying the risk of arrhythmogenic events in cancer patients undergoing ICI therapy. <b>Methods</b>: This retrospective cohort study analyzed 42 patients with cancer who received ICI therapy and had serial 12-lead electrocardiograms (ECGs) performed at baseline and at three-month intervals during the first year of treatment, from May 2022 to November 2023. ECG parameters including PWD, QTd, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were measured and compared between baseline and follow-up time points. <b>Results</b>: The median follow-up duration was 5.3 months (range: 0.5–18.9 months). No statistically significant differences were observed in any of the ECG parameters between baseline and subsequent measurements (<i>p</i> > 0.05). One patient developed atrial fibrillation during the third month of treatment. Additionally, one patient exhibited a left anterior fascicular block, and another experienced frequent ventricular extrasystoles. No malignant ventricular arrhythmias were reported throughout the study period. <b>Conclusions</b>: This study found no significant changes in electrocardiographic markers associated with arrhythmia risk during ICI treatment. Larger, multicenter, prospective studies with extended follow-up are warranted to further elucidate the cardiovascular safety profile of ICIs.
format Article
id doaj-art-0496e14499c541a3932d3f2fa1e90b3d
institution Kabale University
issn 2075-4418
language English
publishDate 2025-05-01
publisher MDPI AG
record_format Article
series Diagnostics
spelling doaj-art-0496e14499c541a3932d3f2fa1e90b3d2025-08-20T03:47:49ZengMDPI AGDiagnostics2075-44182025-05-011510123510.3390/diagnostics15101235Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using ElectrocardiogramAlper Coskun0Ece Celebi Coskun1Ahmet Bilgehan Sahin2Fatih Levent3Eyup Coban4Fatih Koca5Seda Sali6Omer Furkan Demir7Adem Deligonul8Erhan Tenekecioglu9Erdem Cubukcu10Fahriye Vatansever Agca11Turkkan Evrensel12Department of Medical Oncology, School of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, 16310 Bursa, TurkeyDepartment of Medical Oncology, School of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, 16310 Bursa, TurkeyDepartment of Medical Oncology, School of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, 16310 Bursa, TurkeyDepartment of Medical Oncology, University of Health Sciences, Bursa City Hospital, 16250 Bursa, TurkeyDepartment of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, 16310 Bursa, TurkeyDepartment of Medical Oncology, School of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, 16310 Bursa, TurkeyDepartment of Medical Oncology, School of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Cardiology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, 16310 Bursa, TurkeyDepartment of Medical Oncology, School of Medicine, Bursa Uludag University, 16059 Bursa, Turkey<b>Background/Objectives</b>: Immune checkpoint inhibitor (ICI)-associated cardiovascular adverse events are relatively uncommon; they can be life-threatening, particularly when involving malignant ventricular arrhythmias. Electrocardiographic markers such as P-wave dispersion (PWD), QT dispersion (QTd), T-peak to T-end (Tp-e) interval, and Tp-e/QT and Tp-e/QTc ratios have been linked to an elevated risk of both atrial and ventricular arrhythmias and sudden cardiac death across various cardiac conditions. Monitoring these parameters may aid in identifying the risk of arrhythmogenic events in cancer patients undergoing ICI therapy. <b>Methods</b>: This retrospective cohort study analyzed 42 patients with cancer who received ICI therapy and had serial 12-lead electrocardiograms (ECGs) performed at baseline and at three-month intervals during the first year of treatment, from May 2022 to November 2023. ECG parameters including PWD, QTd, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were measured and compared between baseline and follow-up time points. <b>Results</b>: The median follow-up duration was 5.3 months (range: 0.5–18.9 months). No statistically significant differences were observed in any of the ECG parameters between baseline and subsequent measurements (<i>p</i> > 0.05). One patient developed atrial fibrillation during the third month of treatment. Additionally, one patient exhibited a left anterior fascicular block, and another experienced frequent ventricular extrasystoles. No malignant ventricular arrhythmias were reported throughout the study period. <b>Conclusions</b>: This study found no significant changes in electrocardiographic markers associated with arrhythmia risk during ICI treatment. Larger, multicenter, prospective studies with extended follow-up are warranted to further elucidate the cardiovascular safety profile of ICIs.https://www.mdpi.com/2075-4418/15/10/1235arrhythmiacancercardiotoxicityelectrocardiographyimmunotherapy
spellingShingle Alper Coskun
Ece Celebi Coskun
Ahmet Bilgehan Sahin
Fatih Levent
Eyup Coban
Fatih Koca
Seda Sali
Omer Furkan Demir
Adem Deligonul
Erhan Tenekecioglu
Erdem Cubukcu
Fahriye Vatansever Agca
Turkkan Evrensel
Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram
Diagnostics
arrhythmia
cancer
cardiotoxicity
electrocardiography
immunotherapy
title Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram
title_full Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram
title_fullStr Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram
title_full_unstemmed Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram
title_short Prediction of Cardiac Arrhythmias in Cancer Patients Treated with Immune Checkpoint Inhibitors Using Electrocardiogram
title_sort prediction of cardiac arrhythmias in cancer patients treated with immune checkpoint inhibitors using electrocardiogram
topic arrhythmia
cancer
cardiotoxicity
electrocardiography
immunotherapy
url https://www.mdpi.com/2075-4418/15/10/1235
work_keys_str_mv AT alpercoskun predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT ececelebicoskun predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT ahmetbilgehansahin predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT fatihlevent predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT eyupcoban predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT fatihkoca predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT sedasali predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT omerfurkandemir predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT ademdeligonul predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT erhantenekecioglu predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT erdemcubukcu predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT fahriyevatanseveragca predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram
AT turkkanevrensel predictionofcardiacarrhythmiasincancerpatientstreatedwithimmunecheckpointinhibitorsusingelectrocardiogram