Arrhythmias in systemic lupus erythematosus

Area of Science:

• Cardiology
• Rheumatology
• Immunology

Background:

• Cardiac involvement affects over 50% of Systemic Lupus Erythematosus (SLE) patients.
• Prevalence studies and predictive laboratory markers for arrhythmias in SLE are lacking.
• Arrhythmias may explain the sudden cardiac deaths contributing to SLE's second mortality peak.

Purpose of the Study:

• To investigate the prevalence of cardiac arrhythmias in SLE patients.
• To identify potential laboratory correlations predictive of arrhythmia development.
• To understand the pathophysiological mechanisms underlying cardiac arrhythmias in SLE.

Main Methods:

• Review of existing literature on cardiac arrhythmias in SLE.
• Analysis of pathophysiological mechanisms including autoimmune processes, atherosclerosis, and drug toxicity (e.g., chloroquine).
• Discussion of reported arrhythmias such as AV blocks, sick sinus syndrome, tachycardias, and Long QT syndrome.

Main Results:

• Various arrhythmias including AV blocks, intraventricular conduction disturbances, sick sinus syndrome, sinus tachycardia, atrial fibrillation, and atrial ectopies are described in SLE.
• Long QT syndrome and late potentials on signal-averaged ECG are associated with increased mortality.
• Chloroquine cardiotoxicity is a potential cause of arrhythmias, though rarely reported.

Conclusions:

• Arrhythmias are a significant concern in SLE, potentially linked to mortality.
• Complete cardiologic evaluation, including the conduction system, is essential for all SLE patients.
• Early identification and management of arrhythmias can prevent symptoms and sudden cardiac death.