Characteristics of arrhythmias and conduction disturbance in patients with scleroderma

Introduction: Patients with scleroderma have a high prevalence of arrhythmias and conduction disturbances. The substrate of these disorders is represented by myocardial fibrosis, frequently present in these patients as a result of repeated ischemic episodes involving the small coronary arteries. The aim of the present study was to characterize arrhythmias and conduction disturbances in patients with scleroderma from a University Hospital in Romania using the 12 lead ECG and 24 hour Holter ECG monitoring. Methods: 69 patients (65 women) with an average age of 52 ± 12 years (42 – 59) diagnosed with scleroderma (32 with systemic sclerosis, 37 with limited scleroderma), admitted at the Rheumatology Clinic from ClujNapoca between January 2012 and May 2014, were included in the study. All patients underwent a complete physical exam, a resting 12 lead ECG and 24 hour Holter ECG monitoring. Patients treated with antiarrhythmic drugs were not included in the study. Results: Using both diagnostic methods, 40 patients (57.9%) were found with arrhythmias or conduction disturbances. On the ECG, 3 patients (4.3%) had arrhythmias, 11 patients (15.9%) conduction disturbances and 10 patients (14.4%) both. The arrhythmias found were: sinus bradycardia (n = 6), sinus tachycardia (n = 1), AFib (n = 1), supraventricular (n = 8) and ventricular extrasystoles (n = 7). The conduction disturbances were: 1st degree AV block (n = 1), LBBB (n = 2), complete RBBB (n = 3), incomplete RBBB (n = 8), LAHB (n = 6) and nonspecific interventricular conduction delay (n = 2). Using the 24 hour Holter ECG monitoring, 31 patients (44.9%) were diagnosed with arrhythmias, of which 15 patients (21.7%) with ventricular arrhythmias, 9 patients (13%) with supraventricular arrhythmias and 7 patients (10.1%) with both Conclusions: The prevalence of arrhythmias and conduction disturbances is high in patients with scleroderma. The 12 lead ECG and the 24 hour Holter monitor are 2 simple methods capable of identifying patients with arrhythmias and conduction disturbances.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)