REVIEW - Arrhythmias and conduction defects in rheumatological diseases

[Guest guest]

Semin Arthritis Rheum. 2008 Jun 26. [Epub ahead of print]

Arrhythmias and Conduction Defects in Rheumatological Diseases-A

Comprehensive Review.

Eisen A, Arnson Y, Dovrish Z, Hadary R, Amital H.

Department of Medicine D, Meir Medical Center, Kefar-Saba, Israel,

affiliated to Sackler Faculty of Medicine, Tel-Aviv University,

Tel-Aviv, Israel.

OBJECTIVES: To review the clinical aspects of cardiac arrhythmias and

conduction disturbances in several common and less encountered adult

rheumatic diseases and to underline the importance of prompt diagnosis

and management in these patients.

METHODS: The PubMed database was searched for articles published

between the years 1960 and 2008 for keywords referring to autoimmune

diseases. All relevant English-written articles were reviewed. Most

were uncontrolled series and case reports, due to the lack of

prospective studies and randomized trials.

RESULTS: Rheumatologic conditions may affect the cardiovascular system

and increase morbidity and mortality. Rhythm and conduction defects

are usually mild but may be life-threatening; in certain diseases,

such as in systemic lupus erythematosus they may resolve following

therapy with corticosteroids. Conduction defects occur frequently in

patients with spondyloarthropathies and in those with various forms of

vasculitis. Enhanced variation of the QT interval may be a sensitive

marker of a higher arrythmogenic tendency in patients with autoimmune

conditions.

CONCLUSIONS: It is important to identify patients at high risk for

cardiac arrhythmias. Treating such patients with arrhythmias should

not differ fundamentally from other patients. Nevertheless,

appropriate clinical attention and judgment should be applied to

exclude the possibility that arrhythmias reflect uncontrolled

myocardial inflammation.

PMID: 18585758

http://www.ncbi.nlm.nih.gov/pubmed/18585758

Not an MD