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Management of cardiac arrhythmias in patients with autoimmune disease—Insights from EHRA Young Electrophysiologists
Author(s) -
Gawałko Monika,
Peller Michał,
Balsam Paweł,
Grabowski Marcin,
Kosiuk Jędrzej
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14036
Subject(s) - medicine , atrial fibrillation , cardiac arrhythmia , cardiology , amiodarone , catheter ablation , cardiac electrophysiology , heart disease , electrophysiology
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.