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This document discusses the feasibility of using CD19 CAR T-cell therapy in patients with cardiac lymphoma. The article highlights that cardiac non-Hodgkin lymphoma is not well-represented in medical literature, and the exact incidence is unknown. The authors present three cases of patients with cardiac lymphoma who received CAR T-cell therapy. The first two patients had successful outcomes with no significant cardiac events, while the third patient experienced severe cardiotoxicity after CAR T infusion. The authors suggest that a multidisciplinary approach and preventive measures for severe cytokine release syndrome are important in optimizing the safety and efficacy of CAR T-cell therapy in patients with cardiac lymphoma. [Extracted from the article]

Background Ventricular fibrillation in patients with Brugada syndrome (BrS) is often initiated by premature ventricular contractions (PVCs). Presence of SCN5A mutation increases the risk of PVCs upon exposure to sodium channel blockers (SCB) in patients with baseline type-1 ECG. In patients without baseline type-1 ECG, however, the effect of SCN5A mutation on the risk of SCB-induced arrhythmia is unknown. We aimed to establish whether presence/absence, type, and topology of SCN5A mutation correlates with PVC occurrence during ajmaline infusion. Methods and results We investigated 416 patients without baseline type-1 ECG who underwent ajmaline testing and SCN5A mutation analysis. A SCN5A mutation was identified in 88 patients ( S + ). Ajmaline-induced PVCs occurred more often in patients with non-missense mutations ( S non-missense ) or missense mutations in transmembrane or pore regions of SCN5A -encoded channel protein ( S missense-TP ) than patients with missense mutations in intra-/extracellular channel regions ( S missense-IE ) and patients without SCN5A mutation ( S − ) (29%, 24%, 9%, and 3%, respectively; P < 0.001). The proportion of patients with ajmaline-induced BrS was similar in different mutation groups but lower in S − (71% S non-missense , 63% S missense-TP , 70% S missense-IE , and 34% S − ; P < 0.001). Logistic regression indicated S non-missense and S missense-TP as predictors of ajmaline-induced PVCs. Conclusions SCN5A mutation is associated with an increased risk of drug-induced ventricular arrhythmia in patients without baseline type-1 ECG. In particular, S non-missense and S missense-TP are at high risk. [ABSTRACT FROM AUTHOR]