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Review
. 2021 Apr;10(1):17-25.
doi: 10.15420/aer.2020.43.

Arrhythmias and Conduction Disturbances in Autoimmune Rheumatic Disorders

Sotiris C Plastiras  1 , Haralampos M Moutsopoulos  2
Affiliations
Review

Arrhythmias and Conduction Disturbances in Autoimmune Rheumatic Disorders

Sotiris C Plastiras et al. Arrhythm Electrophysiol Rev. 2021 Apr.

Abstract

Rhythm and conduction disturbances and sudden cardiac death are important manifestations of cardiac involvement in autoimmune rheumatic diseases (ARD), which have a serious impact on morbidity and mortality. While the underlying arrhythmogenic mechanisms are multifactorial, myocardial fibrosis plays a pivotal role. It accounts for a substantial portion of cardiac mortality and may manifest as atrial and ventricular arrhythmias, conduction system abnormalities, biventricular cardiac failure or sudden death. In patients with ARD, myocardial fibrosis is considered to be the hallmark of cardiac involvement as a result of inflammatory process or to coronary artery occlusive disease. Myocardial fibrosis constitutes the pathological substrates for reentrant circuits. The presence of supraventricular extra systoles, tachyarrhythmias, ventricular activity and conduction disturbances are not uncommon in patients with ARDs, more often in systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, inflammatory muscle disorders and anti-neutrophil cytoplasm antibody-associated vasculitis. In this review, the type, the relative prevalence and the underlying mechanisms of rhythm and conduction disturbances in the emerging field of cardiorheumatology are provided.

Keywords: Autoimmune systemic disorders; arrhythmias; conduction disturbances; heart involvement.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Arrhythmias in Scleroderma Heart Disease: MRI Findings
Figure 2:
Figure 2:. Hypertrophic Cardiomyopathy in Scleroderma
Figure 3:
Figure 3:. Ventricular Arrhythmias in Lupus Myocarditis
Figure 4:
Figure 4:. Arrhythogenic Right Ventricular Cardiomyopathy in Scleroderma: MRI Findings
Figure 5:
Figure 5:. Right Ventricular Involvement Detected by MRI on Probability of Survival in Patients with Systemic Sclerosis
See this image and copyright information in PMC

References

    1. Wahren-Herlenius M,, Dörner T. Immunopathogenic mechanisms of systemic autoimmune disease. Lancet. 2013;382:819–31. doi: 10.1016/S0140-6736(13)60954-X. - DOI - PubMed
    1. Seferović PM,, Ristić AD,, Maksimović R, et al. Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases. Rheumatology (Oxford) 2006;45::iv39–42. doi: 10.1093/rheumatology/kel315. - DOI - PubMed
    1. Lee HC,, Huang KT,, Wang XL,, Shen WK. Autoantibodies and cardiac arrhythmias. Heart Rhythm. 2011;8:1788–95. doi: 10.1016/j.hrthm.2011.06.032. - DOI - PMC - PubMed
    1. Giannelou M,, Mavragani CP. Cardiovascular disease in systemic lupus erythematosus: a comprehensive update. J Autoimmun. 2017;82:1–12. doi: 10.1016/j.jaut.2017.05.008. - DOI - PubMed
    1. Theodorou E,, Nezos A,, Antypa E, et al. B-cell activating factor and related genetic variants in lupus related atherosclerosis. J Autoimmun. 2018;92:87–92. doi: 10.1016/j.jaut.2018.05.002. - DOI - PubMed

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