Evidence map›Paper›PMID 41412956›Full record

ArticleAnnals of clinical and translational neurology2026

Life-Threatening Bradycardia in Anti-NMDA-Receptor Encephalitis and a Novel Use for Permanent Pacing.

Sarah Tucker, Abhijit Das, Andres Jimenez, Areeba Basit, Yike Jiang, Emily A Smitherman, Heather Van Mater, Taylor Howard, Alexander J Sandweiss, Kristen S Fisher

Abstract read
In one paragraph

Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Autoimmune Encephalitis in Acute Care-Pathology, Diagnosis, and Management.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sarah TuckerDepartment of Pediatrics, Division of Cardiology, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.ORCID 0009-0003-2765-985X
Abhijit DasDepartment of Pediatrics, Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.
Andres JimenezDepartment of Pediatrics, Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.
Areeba BasitMemorial Division of Pediatric Neurology, Joe DiMaggio Children's Hospital, Florida, USA.
Yike JiangDepartment of Pediatrics, Division of Pediatric Rheumatology, Duke University School of Medicine, Durham, USA.
Emily A SmithermanDepartment of Pediatrics, Division of Pediatric Rheumatology, University of Alabama, Alabama, USA.
Heather Van MaterDepartment of Pediatrics, Division of Pediatric Rheumatology, Duke University School of Medicine, Durham, USA.
Taylor HowardDepartment of Pediatrics, Division of Cardiology, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.
Alexander J SandweissDepartment of Pediatrics, Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.ORCID 0000-0002-8213-2941
Kristen S FisherDepartment of Pediatrics, Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.

Funding

Duke Center for Advancement of Child Health (CAtCH)K12HD105253 · NICHD · DUKE UNIVERSITY · PI Corinne Mary Linardic, Ann M. Reed · 2021 to 2026
$1.5M
NICHD NIH HHS K12 HD105253Texas Children's Hospital
6 · The paper itself

Abstract

backgroundPediatric anti-NMDA receptor encephalitis (pNMDARE) is an autoantibody-mediated disorder that can cause severe autonomic dysfunction, including symptomatic bradycardia and asystole. Dysautonomia can last for years, making it very challenging to manage.

objectiveTo describe outcomes of 5 pNMDARE patients with life-threatening bradycardic and/or asystolic events who were managed with permanent or semi-permanent pacemaker implantation.

methodsWe performed a retrospective chart review of 5 patients from multiple institutions. We included patients with a diagnosis of pNMDARE (confirmed by positive cerebrospinal fluid and/or serum anti-NMDAR antibodies) who had a permanent or semi-permanent pacemaker placed due to symptomatic bradycardia, sinus pauses, and/or asystole. Assessed outcomes included mortality, the presence of additional bradycardic/asystolic events after pacemaker implantation, pacemaker complications (lead/device infection, device malfunction), and the ongoing need for ventricular pacing.

resultsFour patients had permanent pacing systems placed, and one patient had a semi-permanent pacemaker placed. Three patients required continued intermittent ventricular pacing months to years after disease onset. None of the patients had further episodes of symptomatic bradycardia or asystole after pacemaker implantation. One patient, who had a severe, intractable form of pNMDARE, died after discontinuing immunotherapies; she had multiple pacemaker interrogations that demonstrated no sign of pacemaker dysfunction.

conclusionPermanent and semi-permanent pacemakers are a safe, effective management strategy for cases of pNMDARE with prolonged courses of severe bradycardia and/or asystole.

Indexed as

Anti-N-Methyl-D-Aspartate Receptor EncephalitisBradycardiaCardiac Pacing, ArtificialHeart ArrestPacemaker, ArtificialAdolescentChildChild, PreschoolFemaleHumansMaleRetrospective Studiesautonomic dysfunctionbradycardialeadless pacemakerpacemakerpediatric anti‐NMDA receptor encephalitis

Identifiers

PMID41412956
PMCPMC13161867

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.