Preliminary evidence of cardiac dysfunction in subacute sclerosing panencephalitis: a systematic review and meta-analysis.

Purpose: Subacute sclerosing panencephalitis (SSPE) is a catastrophic neurological disorder that typically presents in infancy and early adolescence. Cardiac arrhythmia in SSPE is a significant but often under-recognized complication of the disease. The persistent measles virus infection that characterizes SSPE can have widespread effects on the central nervous system, including areas that regulate autonomic function, which in turn can impact cardiac rhythm. In this article, we aim to comprehensively review articles describing cardiac dysfunction associated with SSPE. Methods: We conducted a literature search in PubMed, Scopus, ProQuest, Emerald, and Google Scholar databases of articles published till October, 2025, identified items for review, and conducted a meta-analysis. Results: A total of 947 results were identified across five databases, with 378 studies initially screened, and 569 articles were excluded (10 duplicates and 559 unrelated to the study). Only 4 articles met the eligibility criteria. Our meta-analysis of the three studies showed a pooled mean difference of 11.20 beats per minute (95% confidence interval, 5.52-16.88), with case groups having significantly higher heart rates than controls. Conclusion: The few available studies provide preliminary evidence suggesting that cardiac autonomic disturbances, including elevated heart rates and reduced HRV, occur in a subset of patients with SSPE. More rigorously designed investigations are needed to clarify the prevalence, mechanisms, and clinical impact of cardiac dysfunction in SSPE.