Cardiac rhythm disturbance in human immunodeficiency virus (HIV)-positive patients ranges from benign arrhythmias that may need no treatment to various malignant arrhythmias associated with substantial morbidity and mortality. Common electrocardiographic abnormalities associated with HIV disease are a mildly prolonged QT interval, nonspecific ST-T changes, low voltage, intraventricular conduction delay, and unifocal as well as multiform ventricular premature complexes. Nonsustained ventricular tachycardia is reported in 15%-23% of patients with myocarditis. Sustained ventricular tachycardia and sudden death are encountered more commonly in the presence of sepsis, hypoxia, Pneumocystis carinii pneumonia, pulmonary hypertension, and coronary artery disease. Pericardial and myocardial involvement in Kaposi's sarcoma and non-Hodgkin's lymphomas, as well as chemotherapy or radiation therapy, may be associated with supraventricular or ventricular tachyarrhythmias. Drug-induced prolonged QT interval and torsades de pointes are related primarily to antibiotic use. Electrolyte imbalance, including hypokalemia, hypomagnesemia, and hypocalcemia associated with i.v. amphotericin, foscarnet, and pentamidine therapy and with gastrointestinal disease, may also precipitate malignant ventricular arrhythmias. The cardiomyopathy of acquired immunodeficiency syndrome (AIDS) usually does not respond to the current antiretroviral medications. Therefore, antiarrhythmic therapy in the context of AIDS is directed at the underlying cause and correction of various precipitating factors.
|Original language||English (US)|
|Journal||Cardiovascular Reviews and Reports|
|State||Published - Jan 1 2002|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine