Heart Rate Turbulence Impairment and Ventricular Arrhythmias in Patients with Systemic Sclerosis

Background:  Arrhythmias, conduction disturbances, and cardiac autonomic nervous system dysfunction are the most frequent cardiovascular complications in systemic sclerosis (scleroderma). The aim of the study was to assess heart rate turbulence (HRT) in systemic sclerosis patients and to identify th...

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Published in:Pacing and clinical electrophysiology 2010-08, Vol.33 (8), p.920-928
Main Authors: BIENIAS, PIOTR, CIURZYŃSKI, MICHAŁ, GLIŃSKA-WIELOCHOWSKA, MARIA, KORCZAK, DARIUSZ, KALIŃSKA-BIENIAS, AGNIESZKA, GLIŃSKI, WIESŁAW, PRUSZCZYK, PIOTR
Format: Article
Language:English
Subjects:
Autonomic Nervous System - physiopathology
Biological and medical sciences
cardiac autonomic dysfunction
Cardiac dysrhythmias
Cardiology. Vascular system
Echocardiography
Electrocardiography, Ambulatory
Female
Heart
Heart - innervation
Heart Rate
heart rate turbulence
Humans
Male
Medical sciences
Middle Aged
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Systemic - complications
Scleroderma, Systemic - physiopathology
systemic sclerosis
Tachycardia, Supraventricular - complications
Tachycardia, Supraventricular - physiopathology
ventricular arrhythmias
Ventricular Function, Left
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Summary:Background:  Arrhythmias, conduction disturbances, and cardiac autonomic nervous system dysfunction are the most frequent cardiovascular complications in systemic sclerosis (scleroderma). The aim of the study was to assess heart rate turbulence (HRT) in systemic sclerosis patients and to identify the relationship between HRT and occurrence of arrhythmias. Methods:  Forty‐five patients with scleroderma (aged 54.6 ± 14.7 years) and 30 healthy sex‐ and age‐matched subjects were examined. In addition to routine studies, 24‐hour Holter monitoring with assessment of HRT was performed. Results:  As compared to controls, HRT was significantly impaired in systemic sclerosis patients. Abnormal HRT defined as turbulence onset (TO) ≥0.0% and/or turbulence slope (TS) ≤2.5 ms/RR (ms/RR interval) was found in 19 (42%) scleroderma patients and in no members of the control group. Serious ventricular arrhythmias Lown class IV (VA‐LownIV), for example, couplets and/or nonsustained ventricular tachycardias, were observed in 16 (36%) scleroderma patients. The median value of TS was significantly lower in systemic sclerosis patients with VA‐LownIV than in patients without VA‐LownIV (3.68 vs 7.00 ms/RR, P = 0.02). The area under curve of ROC analysis for prediction of VA‐LownIV was 0.72 (95% confidence interval [CI] 0.56–0.87) and revealed that TS
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.2010.02779.x