Interv Akut Kardiol. 2018;17(4):225-227 | DOI: 10.36290/kar.2018.059

Intermittent high-grade atrioventricular block as a rare extra-articular manifestation of rheumatoid arthritis

Marek Hozman, Alexandr Schee
Kardiocentrum KKN, a.s., Karlovy Vary

High-grade or complete atrioventricular (AV) block is a rare extraarticular manifestation of rheumatoid arthritis (RA). We reporta case of a 34-year-old patient with recurrent syncope. She had been receiving treatment for RA for 17 years. Ambulatory ECGmonitoring revealed an intermittent 2 : 1 and 3 : 1 AV block. No other causes of the conduction system disorder have been found.The patient underwent DDD-R permanent pacemaker implantation.

Keywords: high-grade AV block, rheumatoid arthritis, pacemaker

Published: December 1, 2018  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Hozman M, Schee A. Intermittent high-grade atrioventricular block as a rare extra-articular manifestation of rheumatoid arthritis. Interv Akut Kardiol. 2018;17(4):225-227. doi: 10.36290/kar.2018.059.
Download citation

References

  1. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill, 2012.
  2. Turesson C, O'Fallon WM, Crowson CS, et al. Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years Annals of the Rheumatic Diseases 2003; 62: 722-727. Go to original source... Go to PubMed...
  3. Voskuyl AE. The heart and cardiovascular manifestations in rheumatoid arthritis, Rheumatology, 2006; 45(Suppl. 4): iv4-iv7. Go to original source... Go to PubMed...
  4. Ahern M, Lever JV, Cosh J. Complete heart block in rheumatoid arthritis. Annals of the Rheumatic Diseases 1983; 42(4): 389-397. Go to original source... Go to PubMed...
  5. Sakaria A, Shah K, Desai R, Goel U, Lakhotia A. Complete Heart Block in Rheumatoid Arthritis. Heart India, 2014; 2(2): 56. Go to original source...
  6. Guerrero-Márquez FJ, Arana-Rueda E, Pedrote A. Idiopathic Paroxysmal Atrio-Ventricular Block. What is The Mechanism? Journal of Atrial Fibrillation. 2016; 9(3): 1449. Go to original source... Go to PubMed...
  7. Barra SN, Provid?ncia R, Paiva L, Nascimento J, Marques AL. A Review on Advanced Atrioventricular Block in Young or Middle-Aged Adults. Pacing and Clinical Electrophysiology, 2012; 35: 1395-1405. Go to original source... Go to PubMed...
  8. Mavrogeni S, Karabela G, Stavropoulos E, Gialafos E, Sfendouraki E, Kyrou L, Kolovou G. Imaging patterns of heart failure in rheumatoid arthritis evaluated by cardiovascular magnetic resonance. International Journal of Cardiology, 2013; 168(4): 4333-4335. Go to original source... Go to PubMed...
  9. Kobayashi Y, Giles JT, Hirano M, et al. Assessment of myocardial abnormalities in rheumatoid arthritis using a comprehensive cardiac magnetic resonance approach: a pilot study. Arthritis Research & Therapy. 2010; 12(5): R171. Go to original source... Go to PubMed...
  10. Kobayashi H, Kobayashi Y, Yokoe I, Akashi Y, Takei M, Giles JT. Magnetic Resonance Imaging-Detected Myocardial Inflammation and Fibrosis in Rheumatoid Arthritis: Associations With Disease Characteristics and N-Terminal Pro-Brain Natriuretic Peptide Levels. Arthritis Care & Research, 2017; 69: 1304-1311. Go to original source... Go to PubMed...
  11. Katritsis DG, Josephson ME. Electrophysiological Testing for the Investigation of Bradycardias. Arrhythmia & Electrophysiology Review. 2017; 6(1): 24-28. Go to original source... Go to PubMed...
  12. Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace 2013; 15(8): 1070-1118. Go to original source... Go to PubMed...
  13. Gregoratos G, Cheitlin MD, Conill A, Epstein AE, Fellows C, Ferguson TB, Silka MJ. ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary : A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation). Circulation 1998; 97(13): 1325-1335. Go to original source... Go to PubMed...
  14. Leslie T, Cooper and Lori A. Blauwet; When Should High-Grade Heart Block Trigger a Search for a Treatable Cardiomyopathy? Circulation: Arrhythmia and Electrophysiology. 2011;4:260-261, originally published June 14, 2011. Go to original source... Go to PubMed...
  15. Sung MJ, Park SH, Kim SK, Lee YS, Park CY, Choe JY. Complete Atrioventricular Block in Adult Sjögren's Syndrome with Anti-Ro Autoantibody. The Korean Journal of Internal Medicine 2011; 26(2): 213. Go to original source... Go to PubMed...




Interventional Cardiology

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.