BackgroundThe clinical application of targeted anti-programmed cell death protein 1 (PD-1) therapy has significantly improved the prognosis of patients with various advanced malignancies. However, life-threatening immune-related adverse events remain problematic, including rare but highly lethal myocarditis.
Bidirectional ventricular tachycardia (BVT) is a rare but dangerous form of ventricular arrhythmia. If immune checkpoint inhibitor (ICI)–associated myocarditis is complicated with BVT, patients face an extremely high risk of mortality.Case descriptionThe first case was a 45-year-old male with advanced intrahepatic cholangiocarcinoma who experienced sudden chest tightness after receiving 11 cycles of camrelizumab.
Test results showed significantly elevated myocardial injury markers, and electrocardiography (ECG) indicated BVT; cardiac magnetic resonance imaging findings were consistent with acute myocarditis. A diagnosis of PD-1 inhibitor–associated myocarditis complicated with BVT was considered.
Following immunotherapy discontinuation, the patient was treated with steroid therapy, antiarrhythmic drugs, and electrical cardioversion. This led to marked improvements in ICI-associated myocarditis, BVT resolution, and favorable outcomes.
The second case was a 34-year-old female patient with type B1 thymoma who experienced sudden chest tightness, shortness of breath, and fatigue after receiving one second-line cycle of sintilimab.
Frontiers in Immunology published a clinical update in Infectious Disease on 25 May 2026.
The item focuses on Case Report: Two cases of PD-1 inhibitor–associated myocarditis with bidirectional ventricular tachycardia.
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