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...
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MDPI AG
2025-05-01
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| Online Access: | https://www.mdpi.com/2075-4418/15/10/1235 |
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| 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 |
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| 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 |
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