ĐẶC ĐIỂM RỐI LOẠN NHỊP TIM Ở BỆNH NHÂN BỆNH CƠ TIM THÂM NHIỄM AMYLOID CHUỖI NHẸ

Abstract

Objective: To describe the characteristics of cardiac arrhythmias and evaluate mortality outcomes in patients with light-chain cardiac amyloidosis (AL-CA). Methods: A retrospective case series was conducted on 30 AL-CA patients treated at University Medical Center Ho Chi Minh City from July 2017 to January 2025. Clinical and paraclinical characteristics, types of arrhythmias, survival time, and mortality data were collected and analyzed. Appropriate statistical methods were used to compare between groups. Results: Among 30 patients, 20 cases (66.7%) exhibited cardiac arrhythmias, of which 50% presented with two or more concurrent types of arrhythmias. Ventricular arrhythmias were the most common (56.7%), followed by sick sinus syndrome (23.3%) and atrial fibrillation (13.3%). The arrhythmia group had a mortality rate of 95.0%, which was significantly higher than 60.0% in the non-arrhythmia group (p = 0.03). Median survival was 3 months in patients with arrhythmias and 5 months in those without. During a median follow-up of 36 months, four patients without arrhythmias remained alive, including one who survived up to 89 months, whereas only one patient with arrhythmias achieved long-term survival of 133 months. Overall mortality for the cohort was 83.3% (25/30). Conclusion: Cardiac arrhythmias are common and represent an adverse prognostic factor in patients with AL-CA. The findings underscore the importance of early detection, prompt intervention, and multidisciplinary management of arrhythmias to improve patient outcomes.