{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:57:06Z","timestamp":1785761826750,"version":"3.56.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by modulating immune responses, yet they can trigger rare, life-threatening complications such as myocarditis. Diagnosis remains challenging without confirmatory imaging or biopsy, particularly in haemodynamically unstable patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>We report a 65-year-old male with oesophageal cancer who developed refractory ventricular tachycardia three months after initiating toripalimab, a PD-1 inhibitor. Clinical suspicion of ICI-related myocarditis was based on ECG abnormalities (polymorphic ventricular tachycardia, ST-segment elevation), elevated troponin I (peak 7450\u2005ng\/L), and echocardiography showing reduced left ventricular ejection fraction (30%), with coronary angiography excluding significant obstructive disease. Due to haemodynamic instability, cardiac MRI or biopsy was not feasible. Treatment with high-dose methylprednisolone, immunoglobulin, and anti-arrhythmic drugs (amiodarone, esmolol) yielded limited success, with recurrent arrhythmias requiring multiple cardioversions. Following the family's thoughtful decision to forgo extracorporeal membrane oxygenation, the patient passed away shortly after discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case underscores the diagnostic complexity of suspected ICI-related myocarditis and the critical need for early recognition of immune-mediated cardiac toxicity in immunotherapy patients, emphasizing the role of clinical vigilance when definitive diagnostics are unavailable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf540","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:25:38Z","timestamp":1760959538000},"source":"Crossref","is-referenced-by-count":2,"title":["Refractory ventricular arrhythmia in a patient with suspected immune checkpoint inhibitor-related myocarditis: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-6615","authenticated-orcid":false,"given":"Xinhao","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang 310016 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6643-6435","authenticated-orcid":false,"given":"Rui","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine , Hangzhou, Zhejiang 310016 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"2025111112070435100_ytaf540-B1","first-page":"209","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and 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