CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardio-Oncology
This article is part of the Research TopicCase Reports in Cardio-Oncology: 2025View all 10 articles
A Case of Heart Failure Recovery After Non-ischemic Cardiomyopathy Following Chimeric Antigen Receptor T-Cell Therapy
Provisionally accepted
- University of Arkansas for Medical Sciences, Little Rock, United States
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Chimeric Antigen Receptor T-cell (CAR-T) therapy has emerged as a highly promising immunotherapy for cancer treatment. Intensive research is being conducted focusing on adverse effects that CAR-T infusions may have due to the development of cytokine release syndrome (CRS). We aim to highlight a noteworthy case of ventricular tachycardia presented in the setting of acute non-ischemic cardiomyopathy following CRS after CAR-T therapy, along with providing a detailed discussion of subsequent inpatient and outpatient management. A 78-year-old man with a past medical history of prostate adenocarcinoma, hypertension, and type two diabetes mellitus, with no prior cardiac history or heart failure, underwent CAR-T therapy for diffuse large B-cell lymphoma (DLBCL). During the same hospitalization, he developed grade one CRS along with asymptomatic non-sustained ventricular tachycardia which was suspected to be bundle branch reentrant tachycardia (BBRT-VT). An echocardiogram performed after CAR-T infusion revealed a reduced left ventricular ejection fraction (LVEF) of 35%, a significant decline from his baseline LVEF of 51% two months prior. After the development of the ventricular tachyarrhythmia, amiodarone was initiated for rhythm control. However, over the subsequent five months, the patient had multiple hospital admissions for heart failure exacerbations. During this period, his EF declined to 15% when he was referred for implantable cardioverter defibrillator (ICD) implantation before gradually improving with continued amiodarone and guideline-directed medical therapy. Over the next 18 months, his LVEF recovered to 55%, highlighting the potential reversibility of immunotherapy-induced cardiomyopathy complicated by ventricular tachyarrhythmia. This case showcases a prolonged cardiac recovery following complications of CAR-T therapy. It also provides insight into the successful clinical management of a patient due to CAR-T-induced cardiomyopathy in the setting of potentially complex ventricular arrhythmias.
Keywords: Bundle Branch Block Reentrant Tachycardia, CAR-T therapy, cytokine release syndrome, Heart Failure, Nonischemic cardiomyopathy, Tachyarrhythmia, ventricular tachycardia
Received: 08 Apr 2025; Accepted: 19 Dec 2025.
Copyright: © 2025 Spears, Henson, Vellanki, Trikannad and Paydak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Garrett Spears
J. Curran Henson
Hakan Paydak
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