Pacing therapy for immune checkpoint inhibitors-associated atrioventricular block: a single-center cohort study.

IF 2 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

BMC Cardiovascular Disorders Pub Date : 2025-04-24 DOI:10.1186/s12872-025-04764-y

Jiaqi Wang, Fanyi Kong, Yifan Wang, Jiaqi Yu, Yingxian Liu, Wei Wu, Yongtai Liu, Peng Gao, Zhongwei Cheng, Kang'an Cheng, Hua Deng, Jinzhi Lai, Jingbo Fan, Lihua Zhang, Quan Fang, Taibo Chen, Deyan Yang

{"title":"Pacing therapy for immune checkpoint inhibitors-associated atrioventricular block: a single-center cohort study.","authors":"Jiaqi Wang, Fanyi Kong, Yifan Wang, Jiaqi Yu, Yingxian Liu, Wei Wu, Yongtai Liu, Peng Gao, Zhongwei Cheng, Kang'an Cheng, Hua Deng, Jinzhi Lai, Jingbo Fan, Lihua Zhang, Quan Fang, Taibo Chen, Deyan Yang","doi":"10.1186/s12872-025-04764-y","DOIUrl":null,"url":null,"abstract":"Background: ICI-associated myocarditis is an uncommon yet potentially fatal condition, particularly when concomitant with atrioventricular block (AVB) necessitating pacing. The role of pacing therapy for ICI-associated AVB remains unknown.Objectives: The aim of this study is to investigate the efficacy and safety of pacing therapy for ICI-associated AVB.Methods: Patients with ICI-associated myocarditis admitted to Peking Union Medical College Hospital from May 1st 2019 to April 30th 2024 were consecutively screened and the patients with AVB requiring pacing therapy were retrospectively included. Baseline clinical characteristics and initial temporary pacing therapy were evaluated. Follow-up assessments were conducted to evaluate the survival rate and the recovery of atrioventricular conduction.Results: A total of 43 patients with ICI-associated myocarditis were screened. Among them, a total of 11 (11/43, 25.6%) patients (mean age 64.5 ± 8.6 years, female 18.2%) were diagnosed with advanced or complete AVB and subsequently underwent pacing therapy. Short-term (within 90-days after procedure) survival rate was 72.7% (8/11). Atrioventricular conduction recovered in 4 (4/11, 36.4%) patients, without AVB recurrence after temporary pacemaker removal. For safety endpoints, right ventricular (RV) pacing parameters including pacing threshold, sensing amplitude and impedance were acceptable and no procedure-related complications occurred except RV temporary active fixation lead dislodgement in 1 patient (1/11, 9.1%). No pacing system related-infection occurred.Conclusions: Pacing therapy for ICI-associated AVB demonstrates both safety and efficacy. ICI-associated AVB shows a high rate of recovery. Temporary pacemaker with active fixation lead may be a reasonable option for the initial pacing therapy.","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"319"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023490/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Cardiovascular Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12872-025-04764-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: ICI-associated myocarditis is an uncommon yet potentially fatal condition, particularly when concomitant with atrioventricular block (AVB) necessitating pacing. The role of pacing therapy for ICI-associated AVB remains unknown.

Objectives: The aim of this study is to investigate the efficacy and safety of pacing therapy for ICI-associated AVB.

Methods: Patients with ICI-associated myocarditis admitted to Peking Union Medical College Hospital from May 1st 2019 to April 30th 2024 were consecutively screened and the patients with AVB requiring pacing therapy were retrospectively included. Baseline clinical characteristics and initial temporary pacing therapy were evaluated. Follow-up assessments were conducted to evaluate the survival rate and the recovery of atrioventricular conduction.

Results: A total of 43 patients with ICI-associated myocarditis were screened. Among them, a total of 11 (11/43, 25.6%) patients (mean age 64.5 ± 8.6 years, female 18.2%) were diagnosed with advanced or complete AVB and subsequently underwent pacing therapy. Short-term (within 90-days after procedure) survival rate was 72.7% (8/11). Atrioventricular conduction recovered in 4 (4/11, 36.4%) patients, without AVB recurrence after temporary pacemaker removal. For safety endpoints, right ventricular (RV) pacing parameters including pacing threshold, sensing amplitude and impedance were acceptable and no procedure-related complications occurred except RV temporary active fixation lead dislodgement in 1 patient (1/11, 9.1%). No pacing system related-infection occurred.

Conclusions: Pacing therapy for ICI-associated AVB demonstrates both safety and efficacy. ICI-associated AVB shows a high rate of recovery. Temporary pacemaker with active fixation lead may be a reasonable option for the initial pacing therapy.

查看原文本刊更多论文

起搏治疗免疫检查点抑制剂相关房室传导阻滞：一项单中心队列研究

背景：ici相关性心肌炎是一种罕见但潜在致命的疾病，特别是当合并房室传导阻滞（AVB）需要起搏时。起搏治疗在ici相关AVB中的作用尚不清楚。目的：本研究的目的是探讨起搏治疗ici相关性AVB的有效性和安全性。方法：连续筛选2019年5月1日至2024年4月30日北京协和医院住院的ci相关性心肌炎患者，回顾性纳入需要起搏治疗的AVB患者。评估基线临床特征和初始临时起搏治疗。随访观察生存率及房室传导恢复情况。结果：共筛选出43例ci相关性心肌炎患者。其中11例（11/43,25.6%）患者（平均年龄64.5±8.6岁，女性18.2%）被诊断为晚期或完全性AVB，随后接受了起搏治疗。短期（术后90天内）生存率为72.7%（8/11）。4例（4/11,36.4%）患者房室传导恢复，暂取起搏器后无AVB复发。对于安全性终点，右心室起搏参数包括起搏阈值、感应振幅和阻抗均可接受，除1例右心室临时主动固定导联脱位外，未发生手术相关并发症（1/11,9.1%）。无起搏系统相关感染发生。结论：起搏治疗ici相关性AVB具有安全性和有效性。ci相关性AVB恢复率高。带主动固定导联的临时起搏器可能是初始起搏治疗的合理选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Cardiovascular Disorders CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.50

自引率

0.00%

发文量

480

审稿时长

1 months

期刊介绍： BMC Cardiovascular Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the heart and circulatory system, as well as related molecular and cell biology, genetics, pathophysiology, epidemiology, and controlled trials.