JACC. Case reports · 2026
Secondary Cardiac Lymphoma Causing High-Grade Heart Block: Pacemaker Considerations in an Unpredictable Clinical Course.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sollee John, Peigh Graham, Patil Kaustubha, Lin Albert, Akhter Nausheen, Karmali Reem
Аннотация
BACKGROUND: Cardiac lymphoma can cause rapidly progressive high-grade atrioventricular block by infiltrating the conduction system. Because conduction disease may improve with lymphoma-directed therapy, pacemaker decisions are complex.
CASE SUMMARY: A 44-year-old man with lymphoma developed extensive secondary cardiac involvement and progressive conduction system disease. Given the possibility of reversibility with immunotherapy, multidisciplinary discussions and shared decision-making were used to determine whether pacemaker implantation was warranted and to select the most appropriate device. An active-fixation leadless pacemaker was ultimately implanted.
DISCUSSION: This case highlights the uncertainty regarding pacemaker management in cardiac lymphoma. Decisions should be individualized based on expected treatment response, infection risk, and patient preferences.
TAKE-HOME MESSAGES: Cardiac lymphoma may present with rapidly progressive conduction disease, and the degree of reversibility following lymphoma-directed therapy can be difficult to predict. Decisions regarding pacemaker implantation should be individualized and informed by the expected treatment response, infectious and procedural risks, and patient preferences.
CASE SUMMARY: A 44-year-old man with lymphoma developed extensive secondary cardiac involvement and progressive conduction system disease. Given the possibility of reversibility with immunotherapy, multidisciplinary discussions and shared decision-making were used to determine whether pacemaker implantation was warranted and to select the most appropriate device. An active-fixation leadless pacemaker was ultimately implanted.
DISCUSSION: This case highlights the uncertainty regarding pacemaker management in cardiac lymphoma. Decisions should be individualized based on expected treatment response, infection risk, and patient preferences.
TAKE-HOME MESSAGES: Cardiac lymphoma may present with rapidly progressive conduction disease, and the degree of reversibility following lymphoma-directed therapy can be difficult to predict. Decisions regarding pacemaker implantation should be individualized and informed by the expected treatment response, infectious and procedural risks, and patient preferences.