Author + information
- Received May 5, 1983
- Revision received August 1, 1983
- Accepted August 17, 1983
- Published online January 1, 1984.
- Rodney H. Falk, MB, MRCP, FACC*,
- Alan Rubinow, MD and
- Alan S. Cohen, MD, FACP
- ↵*Address for reprints: Rodney H. Falk, MB, Cardiology Department, Boston City Hospital, 818 Harrison Avenue, Boston, Massachusetts 02118.
To determine the prevalence of cardiac arrhythmias in patients with systemic amyloidosis 24 hour electrocardiographic monitoring was performed in 27 patients with primary amyloidosis and in 6 patients with familial amyloid polyneuropathy. All patients underwent echocardiographic studies. Despite a high prevalence of conduction disturbances on standard electrocardiogram, clinically significant bradyarrhythmias were rare (one patient). Complex ventricular arrhythmias (multiform, paired or repetitive beats) occurred in 14 patients (47%) with primary amyloid and 3 patients (50%) with familial amyloid polyneuropathy. The presence of cardiac arrhythmia correlated with heart failure and, more strongly, with an abnormal echocardiogram. There were four sudden deaths, all in patients with abnormal echocardiograms and complex ventricular arrhythmias. These findings suggest that complex ventricular arrhythmia on Hotter monitoring is common in cardiac amyloidosis and may be a harbinger of subsequent sudden cardiac death.
This study was supported in part by grants from the U.S. Public Health Service, Grants AM-04599 and AM-07014 from the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases; Grant AM20613 from the National Institute of Health Multipurpose Arthritis Center; Grant RR533 from the General Clinical Research Centers Branch of the Division of Research Resources, National Institutes of Health, Be-thesda, Maryland; and grants from the Massachusetts Chapter of the Arthritis Foundation, Boston, Massachusetts, the Arthritis Foundation, Atlanta, Georgia, the Swedish Medical Research Council (Project 5941), the Research Fund of King Gustaf V, Stockholm, Sweden and Biomedical Research Grant RR00569, Bethesda, Maryland.
- Received May 5, 1983.
- Revision received August 1, 1983.
- Accepted August 17, 1983.
- American College of Cardiology Foundation