Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: SSc-cardiomyopathy associated conduction abnormalities carry a poor prognosis, but their pathogenesis is unclear. Early detection to prevent complications is essential. ILRs are well-established in cardiology practice. In patients (pts) with SSc and no known cardiac disease, we aimed to test feasibility of the REVEAL® ILR, the spectrum of cardiac conduction abnormalities (CCA) detected & association with CMR abnormality.
Methods: 20 pts with (ACR/EULAR criteria) SSc, with no diabetes &/or more than 1 cardiovascular (CV) risk factor, were assessed for SSc/CV profile & comprehensive CV assessment performed, inc. 3T delayed enhancement-CMR (reported by CMR-cardiologists) & ILR insertion. ILR data was downloaded 3 monthly +/- at pt request if symptomatic. Baseline CMR compared to 30 healthy controls (HC) and 1-year ILR data is reported with CMR. CK/troponin data available by time of ACR.
Results: ILR data was available for 19 pts; 63% female, 84% Caucasian; mean (SD) age 53 (12)years, median (IQR) time from 1
|CMR variable||No arrhythmia N (%)=12 (80)||Arrhythmia N (%)=3 (20)||Unadjusted mean difference (95% CI), p value||Mean difference (95% CI), p value adjusted for age & sex|
|LV mass/EDV, g/ml|
|Presence of LGE||–|
|Distensibility, 10-3mmHg-1||2.04 (-8.17, 12.24), 0.277|
Conclusion: This first ILR in SSc study demonstrates its feasibility and utility in the incidental detection of CCA, including serious cardiac arrhythmias & suggests associated CMR abnormalities. These data support the need for identification of pts at risk that would benefit from ILR & provide insights into the pathogenesis of SSc-cardiomyopathy.
To cite this abstract in AMA style:Bissell LA, Dumitru B, Abignano G, Erhayiem B, Fent G, Swoboda P, McDiarmid A, Greenwood J, Del Galdo F, Andrews J, Plein S, Graham L, Buch M. First Pilot Study of an Implantable Loop Recorder (ILR) in Systemic Sclerosis Detects Significant Cardiac Arrhythmias with CMR Abnormalities [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/first-pilot-study-of-an-implantable-loop-recorder-ilr-in-systemic-sclerosis-detects-significant-cardiac-arrhythmias-with-cmr-abnormalities/. Accessed December 5, 2020.
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