Arrhythmic Complications in the Guillain-Barré Syndrome

The occurrence of cardiac arrhythmia in Guillain-Barré syndrome (GBS) was examined in a retrospective study of 16 consecutive patients with GBS admitted to an intensive care unit primarily for respiratory insufficiency. Bradyarrhythmias, including sinus arrest or atrioventricular block rhythms, and/or tachyarrhythmias, supraventricular as well as ventricular, were observed in 13 patients. Two patients required pacemaker insertion because of recurrent asystolic episodes. Of the four fatalities, however, none were considered cardiac in origin. While clinically apparent autonomic nervous system dysfunction accompanied many of the observed arrhythmias and may be involved in arrhythmogenesis, these patients also suffered from pulmonary, infectious, and thromboembolic complications that could produce similar arrhythmic complications and must also be considered whenever such arrhythmias are seen.