0244: Prognostic value of heart rhythmic events in systemic sclerosis

Abstract

Systemic sclerosis (SSc) is a multi-systemic disease, responsible for the occurrence of fibrosis interesting skin and some organs such as the heart. The rhythm and conduction disturbances are probably one of the main prognostic factors for heart involvement in systemic sclerosis. Conduction disorders are common and generally not serious, and arrhythmias, especially ventricular ones are more threatening. Performing Holter ECG. Shows significant abnormal Heart rhythm disturbances percentage. Make a descriptive analysis of various rhythm disorder and conduction defects in a population of patients with SSc. From December 2010 to June 2014, 234 patients including 205 women and 29 men with systemic sclerosis were included. Each patient underwent a baseline ECG, cardiac echo Doppler looking for heart damages. A cardiac MRI was performed to search a myocardial fibrosis when segmental wall motion abnormalities were found by echo. 50 Holter ECG has been performed. All patients were in sinus rhythm. Supra ventricular, ventricular premature beats or a combination of both were found in 12.8%. Conduction disorders (first degree AV block, Mobitz 1 AVB, ILBBB, LBBB, RBBB, LAHB) were found in 11.5%. There have been 3 ventricular tachycardia and one sudden death among patients treated for ventricular hyperexcitability with myocardial fibrosis. Of the 50 Holter ECG performed, we recorded an episode of paroxysmal ACFA, supra ventricular hyperexcitability in 39 patients (78%), ventricular hyperexcitability in 44 patients (88%), very important in more than half the cases and often associated with myocardial fibrosis. There was no high degree conduction disturbances. Rhythm and conduction disorders are frequently encountered in systemic sclerosis and constitute one of cardiac manifestations affecting the vital prognosis.