Document Detail


Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases.
MedLine Citation:
PMID:  16980722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rhythm and conduction disturbances and sudden cardiac death (SCD) are important manifestations of cardiac involvement in autoimmune rheumatic diseases (ARDs). In patients with rheumatoid arthritis (RA), a major cause of SCD is atherosclerotic coronary artery disease, leading to acute coronary syndrome and ventricular arrhythmias. In systemic lupus erythematosus (SLE), sinus tachycardia, atrial fibrillation and atrial ectopic beats are the major cardiac arrhythmias. In some cases, sinus tachycardia may be the only manifestation of cardiac involvement. The most frequent cardiac rhythm disturbances in systemic sclerosis (SSc) are premature ventricular contractions (PVCs), often appearing as monomorphic, single PVCs, or rarely as bigeminy, trigeminy or pairs. Transient atrial fibrillation, flutter or paroxysmal supraventricular tachycardia are also described in 20-30% of SSc patients. Non-sustained ventricular tachycardia was described in 7-13%, while SCD is reported in 5-21% of unselected patients with SSc. The conduction disorders are more frequent in ARD than the cardiac arrhythmias. In RA, infiltration of the atrioventricular (AV) node can cause right bundle branch block in 35% of patients. AV block is rare in RA, and is usually complete. In SLE small vessel vasculitis, the infiltration of the sinus or AV nodes, or active myocarditis can lead to first-degree AV block in 34-70% of patients. In contrast to RA, conduction abnormalities may regress when the underlying disease is controlled. In neonatal lupus, 3% of infants whose mothers are antibody positive develop complete heart block. Conduction disturbances in SSc are due to fibrosis of sinoatrial node, presenting as abnormal ECG, bundle and fascicular blocks and occur in 25-75% of patients.
Authors:
P M Seferović; A D Ristić; R Maksimović; D S Simeunović; G G Ristić; G Radovanović; D Seferović; B Maisch; M Matucci-Cerinic
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  45 Suppl 4     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-18     Completed Date:  2007-11-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  iv39-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Institute for Cardiovascular Diseases of the Clinical Center of Serbia, Koste Todorovica 8, 11000 Belgrade, Serbia. eseferov@eunet.yu
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / complications*,  physiopathology,  therapy
Autoimmune Diseases / complications*,  physiopathology
Electrocardiography*
Heart Conduction System / physiopathology*
Humans
Rheumatic Diseases / complications*,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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