Systemic Diseases and Heart Block

Card Electrophysiol Clin. 2021 Dec;13(4):721-740. doi: 10.1016/j.ccep.2021.06.011.

Abstract

Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.

Keywords: Amyloidosis; Atrioventricular node; Heart block; Muscular dystrophies; Rheumatologic disorders; Sarcoidosis; Systemic lupus erythematosus; Thyroid disorders.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arrhythmias, Cardiac
  • Heart Block
  • Heart Conduction System
  • Heart Diseases*
  • Humans
  • Myocardium
  • Neuromuscular Diseases*