Cardiac amyloidosis electrocardiogram: Difference between revisions
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** [[Premature ventricular contractions]] | ** [[Premature ventricular contractions]] | ||
==Holter Monitoring== | |||
Reduced [[heart rate variability]] due to [[autonomic dysfunction]] can be observed on Holter monitoring. Reduced [[heart rate variability]] is a predictor of 1-year mortality in cardiac amyloidosis patients.<ref name="pmid11785998">{{cite journal |author=Reyners AK, Hazenberg BP, Reitsma WD, Smit AJ |title=Heart rate variability as a predictor of mortality in patients with AA and AL amyloidosis |journal=[[European Heart Journal]] |volume=23 |issue=2 |pages=157–61 |year=2002 |month=January |pmid=11785998 |doi=10.1053/euhj.2001.2972 |url=}}</ref> This lack of variability in the heart rate was shown to be a more consistent predictive parameter of short-term mortality in patients with [[AL type amyloidosis]] with cardiac involvement as compared to those with [[AA type amyloidosis]]. | |||
==References== | ==References== | ||
Revision as of 22:00, 29 October 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Aarti Narayan, M.B.B.S [3]; Cafer Zorkun, M.D., Ph.D. [4]
Overview
The combination of low voltage electrocardiographic pattern and increased thickness of the left ventricular posterior wall and interventricular septum on echocardiogram is highly specific for cardiac amyloidosis. Cardiac conduction and rhythm disturbances are common in cardiac amyloidosis, however, direct infiltration of the specialized conduction tissue of the heart by the amyloid may not account for the majority of these disturbances.
Electrocardiogram
Electrocardiographic findings in cardiac amyloidosis include:[1][2][3]
- Low voltage complexes
- Pseudo-infarct pattern of poor R wave progression
- Left ventricular hypertrophy on electrocardiogram
- Higher degree AV blocks
- Bundle branch blocks: Left bundle branch block is seen in 40% of the patients with wild-type ATTR versus 4% of those with AL amyloid type.
- AV nodal slowing of heart rate
- Arrhythmias such as
Holter Monitoring
Reduced heart rate variability due to autonomic dysfunction can be observed on Holter monitoring. Reduced heart rate variability is a predictor of 1-year mortality in cardiac amyloidosis patients.[4] This lack of variability in the heart rate was shown to be a more consistent predictive parameter of short-term mortality in patients with AL type amyloidosis with cardiac involvement as compared to those with AA type amyloidosis.
References
- ↑ Ridolfi RL, Bulkley BH, Hutchins GM (1977). "The conduction system in cardiac amyloidosis. Clinical and pathologic features of 23 patients". The American Journal of Medicine. 62 (5): 677–86. PMID 871125. Unknown parameter
|month=ignored (help) - ↑ Rahman JE, Helou EF, Gelzer-Bell R; et al. (2004). "Noninvasive diagnosis of biopsy-proven cardiac amyloidosis". Journal of the American College of Cardiology. 43 (3): 410–5. doi:10.1016/j.jacc.2003.08.043. PMID 15013123. Unknown parameter
|month=ignored (help) - ↑ Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M (2005). "Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement". The American Journal of Cardiology. 95 (4): 535–7. doi:10.1016/j.amjcard.2004.10.028. PMID 15695149. Unknown parameter
|month=ignored (help) - ↑ Reyners AK, Hazenberg BP, Reitsma WD, Smit AJ (2002). "Heart rate variability as a predictor of mortality in patients with AA and AL amyloidosis". European Heart Journal. 23 (2): 157–61. doi:10.1053/euhj.2001.2972. PMID 11785998. Unknown parameter
|month=ignored (help)