NPPB and pericardial effusion: Timeframes for outcomes followed accepted conventions in CRT-related cardiotoxicity literature, with acute defined as ≤90 days, subacute as 3-6 months, and chronic as >6 months [2,7,9]. Cardiac outcomes were prioritized if they reflected current standards in cardio-oncology, including pericardial effusion, myocardial fibrosis, arrhythmias, ischemia, heart failure, and validated biomarkers (BNP, troponin) or imaging modalities (MRI, echocardiography).