title: Autoantibody-mediated cardiac arrhythmias: mechanisms and clinical implications.
abstract: Cardiac arrhythmias, including conduction defects and tach- yarrhythmias, represent an important source of morbidity and mortality in industrialized countries. Among the different pathophysiological mechanisms involved in the arrhythmogenesis, an inappropriate activation of the immune system represents a field of recent increasing interest. In fact, a large amount of studies suggest that specific autoantibody may be significantly involved in the pathogenesis of cardiac arrhythmias not only in the course of systemic autoimmune disease, but also in a number of rhythm disorders currently classified as "idiopathic." Although the strongest evidence concerns the relationship between anti-Ro/SSA antibodies and the development of congenital heart block in foetus and newborn, other specific autoantibodies demonstrated the aptitude to affect directly the myocardial tissue, thus producing interference in its bioelectric activity thereby leading to rhythm disorders, also life-threatening. The identification of an immunological autoantibody-mediated mechanism opens new perspectives in the treatment and prevention of cardiac arrhythmias in such patients, including the use of immunosuppressive agents and/or the removal of autoantibodies by immuno-adsorption technique.
authors.affiliation: Department of Clinical Medicine and Immunological Sciences, Division of Clinical Immunology, University of Siena, Siena, Italy. pietroenea@yahoo.it
authors.forename: Pietro Enea
authors.initials: PE
authors.lastname: Lazzerini
authors.forename: Pier Leopoldo
authors.initials: PL
authors.lastname: Capecchi
authors.forename: Francesca
authors.initials: F
authors.lastname: Guideri
authors.forename: Maurizio
authors.initials: M
authors.lastname: Acampa
authors.forename: Enrico
authors.initials: E
authors.lastname: Selvi
authors.forename: Stefania
authors.initials: S
authors.lastname: Bisogno
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.forename: Franco
authors.initials: F
authors.lastname: Laghi-Pasini
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000151:congenital / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D001323:Autoantibodies / Q000009:adverse effects*; D001327:Autoimmune Diseases / Q000151:congenital / Q000453:epidemiology / Q000503:physiopathology; D006329:Heart Conduction System / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D043585:Receptor, Muscarinic M2 / Q000276:immunology; D011943:Receptors, Adrenergic, beta / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D043585:Receptor, Muscarinic M2; D011943:Receptors, Adrenergic, beta