Cardiac arrhythmias, conduction system abnormalities, and autonomic tone in patients with brucellosis

OBJECTIVE: Arrhythmias can occur because of cardiac involvement in pa-tients with brucellosis. We investigated the ef-fect of Brucella (Brucella melitensis) on cardiac arrhythmias in patients without pre-existing ar-rhythmogenic heart disease.PATIENTS AND METHODS: 205 patients with sinus rhythm who were diagnosed with brucello-sis and 205 healthy controls were enrolled. ECG was performed, and the parameters were record-ed for each patient. 24-hour ambulatory ECG (Holter) monitoring was conducted, and the re-cordings were analyzed. The time-domain heart rate variability (HRV) results were evaluated.RESULTS: The average age of the group with brucellosis was 28.9 +/- 6.4 years, and 57.1% were male. The ECG parameters, including P dispersion (Pd), QT dispersion (QTd), corrected QTd (QTcd), T-peak to T-end (TpTe), and corrected TpTe (TpTec) were longer and TpTe/QT, TpTe/QTc, TpTec/QT, and TpTec/QTc ratios were higher in the study group compared to the control group (p<0.05). Holter monitoring recorded 33 (16.1%) patients in the study group and 3 (3%) in the control group with abnor-mal rhythms. In the brucellosis group, low frequen-cy (LF), low/high frequency (LF/HF), and the stan-dard deviation of all R-R intervals (SDNN) values, which are known HRV indicators, were substantial-ly different than in the control group (p<0.001).CONCLUSIONS: We can evaluate the silent involvement of the cardiac conduction system in patients with brucellosis using ECG parame-ters, which is a non-invasive and simple method in terms of feasibility in clinical follow-up.

Automated summary

This study investigated the effect of Brucella infection on cardiac arrhythmias in patients without pre-existing arrhythmogenic heart disease. The results showed that ECG parameters and heart rate variability indicators were significantly different between the Brucella infection group and the control group. ECG parameters can be used as a non-invasive and simple method to evaluate the silent involvement of the cardiac conduction system in patients with brucellosis.