Atrioventricular block and conduction disorders induced by ICIs: Individual patient data systematic review

Abstract

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that enhance T cell-mediated anti-tumor responses but may induce cardiotoxicity, including conduction disorders and atrioventricular blocks (AVB). A systematic review of 30 case reports involving cancer patients treated with ICIs was conducted. The majority of affected patients were in advanced stages of lung and kidney/urothelial cancers, predominantly male, and typically developed AVB within three weeks of therapy, often accompanied by myocarditis. Complete AVB was the most frequently observed disorder, necessitating interruption of therapy and temporary pacing. Less than half of the cases were reversible, and in-hospital mortality was significant. Further research is needed.