Management of cardiac arrhythmias in patients with autoimmune disease-Insights from EHRA Young Electrophysiologists.
autoimmunity
cardiac implantable electronic device
catheter ablation
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
22
05
2020
revised:
07
07
2020
accepted:
09
08
2020
pubmed:
14
8
2020
medline:
12
10
2021
entrez:
14
8
2020
Statut:
ppublish
Résumé
Since arrhythmia treatment in patients with autoimmune disease (AD) is challenging, we aimed to assess the common "real-world" practice in the electrophysiology centers. Twenty-four young electrophysiologists being part of European Heart Rhythm Association filled questionnaire regarding arrhythmia management in AD. Rheumatoid arthritis was the most commonly reported AD accompanied by cardiac arrhythmias. The most frequent observed arrhythmias were atrial fibrillation and premature atrial/ventricular contractions. Most often electrocardiographic abnormalities observed were increased heart rate variability, QT interval prolongation, and P-wave dispersion, whereas echocardiographic abnormalities included left atrial enlargement, pericardial infusion, and left ventricular dysfunction. The most useful tool for arrhythmia management was guidelines and evidence-based medicine, while training courses and websites were at least useful. A close collaboration with other specialists in arrhythmia management was reported in 58.3% of respondents. Glucocorticoids and cytostatic were the most reported arrhythmia-induced drugs, whereas amiodarone and beta-blockers were most effective antiarrhythmic drugs. The main reason that discouraged respondents from cardiac implantable devices implantation and catheter ablation was high infection complications risk and recurrences during long-term follow-up, respectively. Scant data and guidelines enforce exchange of experience to improve the arrhythmia treatment in AD.
Sections du résumé
BACKGROUND
Since arrhythmia treatment in patients with autoimmune disease (AD) is challenging, we aimed to assess the common "real-world" practice in the electrophysiology centers.
METHODS
Twenty-four young electrophysiologists being part of European Heart Rhythm Association filled questionnaire regarding arrhythmia management in AD.
RESULTS
Rheumatoid arthritis was the most commonly reported AD accompanied by cardiac arrhythmias. The most frequent observed arrhythmias were atrial fibrillation and premature atrial/ventricular contractions. Most often electrocardiographic abnormalities observed were increased heart rate variability, QT interval prolongation, and P-wave dispersion, whereas echocardiographic abnormalities included left atrial enlargement, pericardial infusion, and left ventricular dysfunction. The most useful tool for arrhythmia management was guidelines and evidence-based medicine, while training courses and websites were at least useful. A close collaboration with other specialists in arrhythmia management was reported in 58.3% of respondents. Glucocorticoids and cytostatic were the most reported arrhythmia-induced drugs, whereas amiodarone and beta-blockers were most effective antiarrhythmic drugs. The main reason that discouraged respondents from cardiac implantable devices implantation and catheter ablation was high infection complications risk and recurrences during long-term follow-up, respectively.
CONCLUSIONS
Scant data and guidelines enforce exchange of experience to improve the arrhythmia treatment in AD.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1194-1198Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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