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Autoantibody-mediated cardiac arrhythmias: mechanisms and clinical implications

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Abstract

Cardiac arrhythmias, including conduction defects and tach- yarrhythmias, represent an important source of morbidity and mortality in industrialized countries. Among the different pathophysiological mechanisms involved in the arrhythmogenesis, an inappropriate activation of the immune system represents a field of recent increasing interest. In fact, a large amount of studies suggest that specific autoantibody may be significantly involved in the pathogenesis of cardiac arrhythmias not only in the course of systemic autoimmune disease, but also in a number of rhythm disorders currently classified as “idiopathic.” Although the strongest evidence concerns the relationship between anti-Ro/SSA antibodies and the development of congenital heart block in foetus and newborn, other specific autoantibodies demonstrated the aptitude to affect directly the myocardial tissue, thus producing interference in its bioelectric activity thereby leading to rhythm disorders, also life-threatening. The identification of an immunological autoantibody-mediated mechanism opens new perspectives in the treatment and prevention of cardiac arrhythmias in such patients, including the use of immunosuppressive agents and/or the removal of autoantibodies by immuno-adsorption technique.

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Authors and Affiliations

  1. Dept. of Clinical Medicine and Immunological Sciences, Division of Clinical Immunology, University of Siena, Siena, Italy

    Pietro Enea Lazzerini MD, Pier Leopoldo Capecchi, Francesca Guideri & Franco Laghi-Pasini

  2. Division of Internal Medicine, University of Siena, Siena, Italy

    Maurizio Acampa

  3. Division of Rheumatology, University of Siena, Siena, Italy

    Enrico Selvi, Stefania Bisogno & Mauro Galeazzi

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  1. Pietro Enea Lazzerini MD
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  2. Pier Leopoldo Capecchi
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  3. Francesca Guideri
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  5. Enrico Selvi
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  6. Stefania Bisogno
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Correspondence to Pietro Enea Lazzerini MD.

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Returned for 1. revision: 17 September 2007 1. Revision received: 24 September 2007

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Lazzerini, P.E., Capecchi, P.L., Guideri, F. et al. Autoantibody-mediated cardiac arrhythmias: mechanisms and clinical implications. Basic Res Cardiol 103, 1–11 (2008). https://doi.org/10.1007/s00395-007-0686-8

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