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

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Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, 45147 Essen, Germany
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Department of Dermatology, Medical Faculty, University Hospital Essen, 45147 Essen, Germany
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Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2060; https://doi.org/10.3390/jcm9072060
Received: 18 May 2020 / Revised: 18 June 2020 / Accepted: 25 June 2020 / Published: 30 June 2020
(This article belongs to the Special Issue Cardiovascular Precision Medicine)
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. View Full-Text
Keywords: immune checkpoint inhibitor therapy; ECG; QTd; QT dispersion; cardiotoxicity immune checkpoint inhibitor therapy; ECG; QTd; QT dispersion; cardiotoxicity
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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. ECG Changes in Melanoma Patients Undergoing Cancer Therapy—Data from the ECoR Registry. J. Clin. Med. 2020, 9, 2060.

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