Autoimmune bradyarrhythmias

The autoimmune pathogenesis of cardiac conduction system disease is reviewed here (European Heart Journal 2001). The well known association between congenital heart block and maternal antinuclear antibodies (SSA/Ro and SSB/La) is discussed. Less well appreciated conditions are antibodies to sino-atrial node and atrio-ventricular node tissues and their clinical associations with bradycardia, sick sinus syndrome and heart block and the increased incidence of AV block in HLA B-27 positive individuals.