Patients with systemic sclerosis have an increased risk for cardiac arrhythmias. Sebestyen et al reported findings in the ECG that can identify a patient at increased risk. The authors are from the University of Debrecen in Hungary.
Patient selection: systemic sclerosis
Cardiac conditions in systemic sclerosis may include:
(1) pericarditis
(2) myocarditis
(3) arrhythmias
(4) conduction defects
(5) valvopathy
(6) heart failure
20% of patients with systemic sclerosis die from cardiac disease.
6% of patients with systemic sclerosis die from cardiac arrhythmias.
Arrhythmias arise from structural and cellular changes that affect impulse-generating and conduction.
Predictors of ventricular arrhythmias:
(1) prolongation of the QT interval
(2) QT dispersion (the interlead difference between QT intervals)
(3) T wave peak-to-end interval (Tpe)
(4) arrhythmogenicity index (Tpe to QT ratio)
Drugs that prolonged the QT interval should be avoided.
Ventricular arrhythmias may be associated with elevations in serum troponin and NT-proBNP.
