Key result
Immune checkpoint inhibitors link to a ~7% arrhythmia incidence, driven primarily by atrial fibrillation.
Why the study?
Immune checkpoint inhibitors are increasingly associated with cardiovascular immune-related adverse events, including arrhythmias, but their incidence remains incompletely defined.
Meta-Analysis (n=31,542)
Immune checkpoint inhibitors are associated with a measurable burden of arrhythmias, with a pooled incidence of 6.89%, highlighting the need for standardized monitoring in this population.
May inform arrhythmia surveillance during ICI therapy; leaves open need for prospective trials on incidence and prevention.
Immune checkpoint inhibitors (ICIs) are increasingly associated with cardiovascular immune-related adverse events, including arrhythmias, though their incidence remains incompletely defined. PubMed/MEDLINE and Google Scholar were systematically searched from inception to February 2026 for studies reporting arrhythmia outcomes in patients receiving ICIs. A random-effects meta-analysis of proportions was performed. Twenty-two studies were included, of which 13 studies comprising 31,542 patients were included in the quantitative synthesis. The pooled incidence of arrhythmias was 6.89% [95% confidence interval (CI): 4.4–9.4%; I 2 = 99.07%]. Subgroup analyses demonstrated an incidence of atrial fibrillation of 6.8% (95% CI: 0.0–15.3%; I 2 = 95.3%) and conduction disorders of 1.44% (95% CI: 0.0–3.07%; I 2 = 88.5%). ICIs are associated with a measurable burden of arrhythmias, particularly atrial fibrillation. However, substantial heterogeneity limits precision, highlighting the need for prospective studies with standardized monitoring strategies.
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Moudgil et al. (2026) conducted a meta-analysis in Patients receiving immune checkpoint inhibitors (n=31,542). Immune checkpoint inhibitors (ICIs) was evaluated on Incidence of arrhythmias (95% CI 4.4-9.4%). Immune checkpoint inhibitors are associated with a pooled arrhythmia incidence of 6.89% (95% CI 4.4-9.4%), with atrial fibrillation being particularly prominent.
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