Immunotherapy-Related Cardiac Arrythmias: Incidence, Pathobiology, Risk Factors and Management
Abstract
Abstract Purpose of Review Immunotherapies have revolutionized treatment strategies for cancer patients, improving the prognosis in many populations with advanced malignancies. Immune check point inhibitors (ICI) and Chimeric antigen receptor (CAR) T cell therapy are being increasingly used. As the real-world use of immunotherapies increases and indications expand, an understanding of potential cardiovascular toxicities is required. Recent Findings Arrhythmias are among the top reasons for seeking cardiovascular care in immunotherapy treated patients. ICI and CART therapies have been associated with arrhythmias with wide range of estimates reported in randomized clinical trials and retrospective studies. The pathophysiology and risk factors behind ICI and CART therapies is unclear. Summary In this review, we summarize the incidence, mechanisms, risk factors, impact on patient outcomes and management of ICI and CAR-T cell therapy-associated arrhythmia complications.
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Authors: Manyoo A. Agarwal, Fatemeh Mohammad, Arianne Clare Agdamag, Avirup Guha, Eric H. Yang, Fereidoon Shaffei, Ghanem Ismail, Hassan Khan, Ajlan Al Zaki, Stephen Grobmeyer, Michael Fradley, Alexander R. Lyon
Institutions: University of Pennsylvania, University of California, Los Angeles, Case Western Reserve University, Khalifa University of Science and Technology, Abu Dhabi Health Services, Cleveland Clinic, Cleveland Foundation, University School, Cleveland Clinic Lerner College of Medicine, Royal Brompton Hospital, Augusta University, Cleveland Clinic Abu Dhabi