Electrocardiographic features of immune checkpoint inhibitor associated myocarditis.
Publication/Presentation Date
3-1-2021
Abstract
BACKGROUND: Myocarditis is a highly morbid complication of immune checkpoint inhibitor (ICI) use that remains inadequately characterized. The QRS duration and the QTc interval are standardized electrocardiographic measures that are prolonged in other cardiac conditions; however, there are no data on their utility in ICI myocarditis.
METHODS: From an international registry, ECG parameters were compared between 140 myocarditis cases and 179 controls across multiple time points (pre-ICI, on ICI prior to myocarditis, and at the time of myocarditis). The association between ECG values and major adverse cardiac events (MACE) was also tested.
RESULTS: Both the QRS duration and QTc interval were similar between cases and controls prior to myocarditis. When compared with controls on an ICI (93±19 ms) or to baseline prior to myocarditis (97±19 ms), the QRS duration prolonged with myocarditis (110±22 ms, p
CONCLUSIONS: The QRS duration is increased in ICI myocarditis and is associated with increased MACE risk. Use of this widely available ECG parameter may aid in ICI myocarditis diagnosis and risk-stratification.
Volume
9
Issue
3
ISSN
2051-1426
Published In/Presented At
Zlotoff, D. A., Hassan, M., Zafar, A., Alvi, R. M., Awadalla, M., Mahmood, S. S., Zhang, L., Chen, C. L., Ederhy, S., Barac, A., Banerji, D., Jones-O'Connor, M., Murphy, S. P., Armanious, M., Forrestal, B. J., Kirchberger, M. C., Coelho-Filho, O. R., Rizvi, M. A., Sahni, G., Mandawat, A., … Neilan, T. G. (2021). Electrocardiographic features of immune checkpoint inhibitor associated myocarditis. Journal for immunotherapy of cancer, 9(3), e002007. https://doi.org/10.1136/jitc-2020-002007
Disciplines
Medicine and Health Sciences
PubMedID
33653803
Department(s)
Department of Medicine
Document Type
Article