ECG Changes in Melanoma Patients Undergoing Cancer Therapy—Data from the ECoR Registry

GND
1045648663
ORCID
0000-0001-9142-4869
LSF
58039
Affiliation
Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, 45147 Essen, Germany, J.Pohl@uk-essen.de
Pohl, Julia; Mincu, Raluca-Ileana;
GND
112151118X
LSF
58038
Mrotzek, Simone Maria;
GND
1168481546
LSF
59277
Hinrichs, Lena;
LSF
58442
Michel, Lars; Livingstone, Elisabeth;
GND
131597914
LSF
54385
Zimmer, Lisa;
LSF
59276
Wakili, Reza; Schadendorf, Dirk;
GND
122860489
LSF
57589
Rassaf, Tienush;
GND
137120753
LSF
57668
Totzeck, Matthias

We aimed to evaluate whether therapy with immune checkpoint inhibitors (ICI) leads to changes in electrocardiogram (ECG) parameters in melanoma patients. We retrospectively examined 41 patients (46% women, age 61 ± 12years) with advanced melanoma (stage III/IV) before and during ICI treatment from our “Essen Cardio-oncology Registry” (ECoR). ECGs were analyzed before and 4–12 weeks after therapy started (follow-up, 90 ± 51 days). Heart rate, PR time, QRS duration and duration of the corrected QT (QTc) interval were recorded. QT dispersion (QTd) was calculated. Heart rate, PR time, QRS and QTc did not differ when comparing values before and after therapy started. QTd was prolonged after therapy started (32 ± 16 ms vs. 47 ± 19 ms, n = 41, p < 0.0001). Subgroup analyses revealed prolonged QTd in patients that received a combination immunotherapy with ipilimumab and nivolumab (31 ± 14 ms vs. 50 ± 14 ms, n = 21, p < 0.0001), while QTd in patients with anti–programmed death 1 (PD-1) inhibitor monotherapy did not change after therapy started. QTd is prolonged in patients under ICI combination therapy, potentially signaling an increased susceptibility to ventricular arrhythmias.

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Pohl, J., Mincu, R.-I., Mrotzek, S.M., Hinrichs, L., Michel, L., Livingstone, E., Zimmer, L., Wakili, R., Schadendorf, D., Rassaf, T., Totzeck, M., 2020. ECG Changes in Melanoma Patients Undergoing Cancer Therapy—Data from the ECoR Registry. https://doi.org/10.3390/jcm9072060
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