The Incidence of Electrocardiogram Changes Following Rituximab Infusion in Rheumatic Patients

Background: Rheumatism is one of the most common chronic diseases of the musculoskeletal system and connective tissue, which affects different age groups.Objectives: To investigate the incidence of electrocardiogram (ECG) changes following rituximab infusion in rheumatic patients. Methods:This cross-sectional study was conducted on 60 patients with a definite diagnosis of rheumatic diseases with the indication of receiving rituximab.Before the infusion of rituximab (500 mg or 1000 mg), the patients with abnormal ECG changes were excluded from the study.Then, all patients were subjected to complete cardiopulmonary monitoring (including data on heart rate, respiratory rate, blood pressure, and pulse oximetry) during infusion up to 2 hours after receiving rituximab, and the occurrence of changes in ECG was evaluated.Results: Their MeanSD age was 43.409.43years, and their mean heart rate before rituximab infusion was 79.2610.83per minute.Fifty-seven patients (95%) were women.Rheumatoid arthritis (RA), dermatomyositis, and systemic lupus erythematosus (SLE) were the most common rheumatoid disorders, with 43.3%, 23.3%, and 16.7%, respectively.Prednisolone, methotrexate, and hydroxychloroquine were the most commonly used drugs, with 90%, 60%, and 33.3%, respectively.The incidence of ECG abnormalities was 70%.The incidences of premature atrial contractions and sinus tachycardia were 43.3% and 31.3%, respectively.The incidence of premature ventricular contractions (PVCs) was 13.3%.The incidences of sinus bradycardia and ST-T abnormality were 8.3% and 3.3%, respectively.No statistically significant relationship was observed between the incidence of ECG abnormalities with age, sex, heart rate, type of rheumatic disorder, cardiovascular disease risk factors, rituximab dosage, and drug use (P>0.05). Conclusion:The incidence of ECG abnormalities following rituximab infusion in rheumatic patients was 70%, which is high.Therefore, complete cardiopulmonary monitoring of these patients following receiving rituximab seems essential.