Arrhythmias and conduction defects in rheumatological diseases--a comprehensive review.
OBJECTIVE
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.
Eisen
Alon
A
Department of Medicine D, Meir Medical Center, Kefar-Saba, Israel.
Arnson
Yoav
Y
Dovrish
Zamir
Z
Hadary
Ruthy
R
Amital
Howard
H
D000906:Antibodies / Q000097:blood; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology*; D001324:Autoantigens / Q000276:immunology; D006329:Heart Conduction System / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D012216:Rheumatic Diseases / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D012261:Ribonucleoproteins / Q000276:immunology; D012307:Risk Factors; D000097585:SS-B Antigen; D000099207:SS-A Antigen
D000906:Antibodies; D001324:Autoantigens; D012261:Ribonucleoproteins; D000097585:SS-B Antigen; D000099207:SS-A Antigen