Identification of patients at risk of arrhythmia in the Guillain-Barré syndrome.

The frequency of autonomic dysfunction and significant arrhythmia was investigated in a series of 100 patients who presented with an acute idiopathic neuropathy considered to be due to Guillain-Barré syndrome. Eleven of 33 patients requiring ventilation developed serious cardiac rhythm disturbances and seven of these patients died. Approximately 25 per cent of patients had a sinus tachycardia or raised systolic blood pressure and half had reduced sinus arrhythmia indicated by an abnormally low R-R interval variation on deep breathing. Systolic hypertension and reduced R-R interval variation were significantly more common in patients who subsequently developed serious arrhythmias than those who did not. Only those patients that required ventilation developed serious arrhythmias and these were often preceded by wide fluctuations of pulse or blood pressure and transient asystole following tracheal suction.