Background/Purpose: Systemic sclerosis( SSc) can primarily cause repeated focal ischaemic insults in the myocardium and result in irreversible myocardial fibrosis. Myocardial involvement, when becomes clinically apparent, is considered as a poor prognostic factor. Conduction system fibrosis can result in bradyarrhythmia and conduction abnormalities and myocardial fibrosis can cause atrial and ventricular arrhythmia. This study aims to assess incidence of arrhythmia and conduction abnormalities in patients with systemic sclerosis.

Methods: We comprehensively searched the pubmed and embase database with keywords “systemic sclerosis”,”arrhythmia or conduction or AV block” from inception to April 2022. The primary aim of the study was to determine incidence of conduction abnormalities and arrhythmia in systemic sclerosis patients. Incidence was pooled using random effect model using DerSimonian-Laird estimator of Tau2. The heterogeneity of effect size across the studies was assessed with I2 statistics with low heterogeneity: I2 ≤ 25% moderate: 25–50% and high >75%.

Results: Our literature search yielded 2837 studies, of which 33 retrospective and prospective cohort and cross sectional studies involving a total 8225 patients met our inclusion criteria. Systemic sclerosis patients showed a pooled incidence of 21 (17-24)95% ; I2=97% for arrhythmia and conduction blocks.

Conclusion: Arrhythmia and conduction abnormalities can be frequently seen in SSc patients. Taking into account the poor prognosis associated with clinically evident cardiac involvement, electrocardiogram may aid in early detection and can be considered in SSc patients on routine basis, utility of which needs to be studied further.

« Back to ACR Convergence 2022

ACR Meeting Abstracts - https://acrabstracts.org/abstract/cardiac-rhythm-and-conduction-abnormalities-in-systemic-sclerosis-meta-analysis/