ArticleEuropean heart journal. Case reports2026
Reversible complete atrioventricular block in immune checkpoint inhibitor-associated triple-M overlap syndrome: a case report.
Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Immune checkpoint inhibitors (ICIs) are increasingly used in the treatment of advanced malignancies but are associated with rare and potentially life-threatening immune-related adverse events. Overlap syndromes involving myocarditis, myositis, and myasthenia gravis-referred to as Triple-M overlap syndrome-have been reported; however, reversible high-grade atrioventricular block remains uncommon. Case summary: A 74-year-old woman with advanced ovarian cancer treated with pembrolizumab presented with dyspnoea, myalgia, and right-sided ptosis 22 days after ICI therapy. Electrocardiography demonstrated ST-segment elevation in the anterior leads with markedly elevated high-sensitivity troponin. On the following day, persistent ST-segment elevation prompted evaluation for acute myocardial infarction, and coronary angiography revealed no obstructive coronary artery disease. The clinical course was complicated by sustained ventricular tachycardia followed by complete atrioventricular block requiring temporary transvenous pacing. Laboratory evaluation showed markedly elevated creatine kinase, and neurological findings were consistent with neuromuscular junction involvement. Immune-mediated Triple-M overlap syndrome was suspected, and high-dose corticosteroids and intravenous immunoglobulin were initiated. The patient demonstrated progressive clinical improvement, with resolution of arrhythmias and recovery of atrioventricular conduction. Discussion: This case highlights a rare presentation of ICI-associated Triple-M overlap syndrome complicated by reversible complete atrioventricular block. Immune-mediated conduction abnormalities may progress despite improving cardiac biomarkers, and early immunomodulatory therapy may enable reversibility of high-grade atrioventricular block.
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.