ArticleCardio-oncology (London, England)2023
Complete heart block is a significant predictor of mortality in immune checkpoint inhibitor myocarditis.
Article in Cardio-oncology (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Immune checkpoint inhibitor-related myositis, myocarditis, and myasthenia gravis overlap syndrome: a systematic review and pooled analysis of individual cases.Frontiers in immunology · 2026Pooled it
- A narrative review of immune checkpoint inhibitor-related cardiotoxicity in lung cancer: mechanisms, risk stratification, and clinical management.Journal of thoracic disease · 2026Review
- Reversible complete atrioventricular block in immune checkpoint inhibitor-associated triple-M overlap syndrome: a case report.European heart journal. Case reports · 2026Article
- Review
- Electrocardiographic changes in immune checkpoint inhibitor-associated cardiac injury: a narrative review.Cardiovascular diagnosis and therapy · 2026Review
- Nationwide trends and disparities in deaths from second- or third-degree atrioventricular block (1999-2022): A 24-year retrospective analysis of CDC WONDER data.American heart journal plus : cardiology research and practice · 2026Article
- Highly suspected fulminant myocarditis induced by the immune checkpoint inhibitor tislelizumab: a case report with third-degree atrioventricular block and recurrent ventricular tachycardia.Frontiers in cardiovascular medicine · 2026Article
- Integrated risk stratification for ICI-associated myocarditis: a baseline hematological profile and a combined ECG and enzymatic signature at onset.Frontiers in immunology · 2026Article
- A review of immune checkpoint inhibitor-associated myocarditis: Epidemiology, pathogenesis, and biomarkers.Human vaccines & immunotherapeutics · 2025Review
- Article
- Predictors of Long-Term Survival in Patients With Immune Checkpoint Inhibitor-Associated Myocarditis.Journal of the American Heart Association · 2025Article
- Predicting 30-Day Cardiotoxicity in Patients Receiving Immune Checkpoint Inhibitors: An Observational Study Utilizing XGBoost.Cardiovascular toxicology · 2025Observational
- Pacing Solutions for Immune Checkpoint Myocarditis and Associated Conduction Disorders.JACC. Case reports · 2025Article
- Updates in Diagnosis and Treatment of Immune Checkpoint Inhibitor Myocarditis.Current cardiology reports · 2025Review
- Immune checkpoint inhibitor-associated myocarditis: a historical and comprehensive review.American journal of physiology. Heart and circulatory physiology · 2025Review
- Multimodal Fusion Artificial Intelligence Model to Predict Risk for MACE and Myocarditis in Cancer Patients Receiving Immune Checkpoint Inhibitor Therapy.JACC. Advances · 2025Article
- Case Report: Fatal myocarditis and myasthenia gravis induced by immune checkpoint inhibitors: concurrent dual adverse events in an older adult.Frontiers in oncology · 2025Article
- Successful management of complete heart block in checkpoint inhibitor induced myocarditis by left bundle branch area pacing: a case report.European heart journal. Case reports · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmune checkpoint inhibitor (ICI) myocarditis is associated with significant mortality risk. Electrocardiogram (ECG) changes in ICI myocarditis have strong prognostic value. However the impact of complete heart block (CHB) is not well defined. This study sought to evaluate the impact of CHB on mortality in ICI myocarditis, and to identify clinical predictors of mortality and CHB incidence.
methodsWe conducted a retrospective cohort study of patients with ICI myocarditis at three Mayo Clinic sites from 1
resultsOf 34 identified cases of ICI myocarditis, 7 (20.6%) had CHB. CHB was associated with higher mortality (HR 7.41, p = 0.03, attributable fraction 86.5%). Among those with CHB, troponin T (TnT) < 1000 ng/dL, low white blood cell count and high ventricular rate at admission were protective. There was trend towards increased survival among patients who underwent permanent pacemaker insertion (p = 0.051), although most experienced device lead complications. Factors associated with development of CHB included prolonged PR and QRS intervals and low Sokolow Lyon Index. Where these were normal and TnT was < 1000 ng/dL, no deaths occurred. Impaired myocardial longitudinal strain was sensitive for ICI myocarditis but was not prognostically significant.
conclusionThere is a strong temporal association between CHB and early mortality in people with ICI myocarditis. Focusing on arrhythmogenic complications can be helpful in predicting outcomes for this group of critically ill individuals.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.