Paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome in ankylosing spondylitis: a large cohort observation study and literature review

Semin Arthritis Rheum. 2012 Dec;42(3):246-53. doi: 10.1016/j.semarthrit.2012.04.002. Epub 2012 May 19.

Abstract

Objectives: To investigate the associations of paroxysmal supraventricular tachycardia (PSVT) and Wolff-Parkinson-White (WPW) syndrome with ankylosing spondylitis (AS).

Methods: We conducted a retrospective cohort study by reviewing the medical records of 1503 consecutive AS patients diagnosed at a tertiary medical center. The clinical and electrocardiographic (ECG) characteristics of 641 AS patients having 12-lead ECG available were further analyzed in a precise manner.

Results: Among the 641 AS patients with 12-lead ECG available for detecting cardiac abnormalities, 14 were identified as having PSVT, including 3 with WPW syndrome and 1 having a WPW (ventricular preexcitation) ECG pattern. A higher proportion of AS patients presented with PSVT (21.8/1000) compared with a general population-based study (2.25/1000). Also, AS patients demonstrated a higher prevalence of WPW syndrome or WPW pattern (6.24/1000) than found in general population-based studies (0.9 to 1.5/1000). Ankylosing spondylitis patients with PSVT or WPW syndrome had significantly higher rates of peripheral arthritis (78.6%; P = 0.002), acute anterior uveitis (64.3%; P = 0.003), bamboo spine (64.3%; P = 0.001), and other cardiovascular disorders (85.7%; P < 0.0001) than the remaining 627 patients without PSVT.

Conclusions: Ankylosing spondylitis patients had a high probability of developing PSVT and WPW syndrome. Detailed ECG and electrophysiological examinations are required for early detection of PSVT and WPW syndrome for prompt resolution of potentially life-threatening complications in all AS patients, especially those presenting with the symptoms of palpitation, dizziness, dyspnea, or syncope.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Comorbidity
  • Dizziness / diagnosis
  • Dizziness / epidemiology
  • Dizziness / physiopathology
  • Dyspnea / diagnosis
  • Dyspnea / epidemiology
  • Dyspnea / physiopathology
  • Early Diagnosis
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Spondylitis, Ankylosing / diagnosis
  • Spondylitis, Ankylosing / epidemiology*
  • Spondylitis, Ankylosing / physiopathology
  • Syncope / diagnosis
  • Syncope / epidemiology
  • Syncope / physiopathology
  • Tachycardia, Paroxysmal / diagnosis
  • Tachycardia, Paroxysmal / epidemiology*
  • Tachycardia, Paroxysmal / physiopathology
  • Tachycardia, Supraventricular / diagnosis
  • Tachycardia, Supraventricular / epidemiology*
  • Tachycardia, Supraventricular / physiopathology
  • Taiwan / epidemiology
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / epidemiology
  • Uveitis, Anterior / physiopathology
  • Wolff-Parkinson-White Syndrome / diagnosis
  • Wolff-Parkinson-White Syndrome / epidemiology*
  • Wolff-Parkinson-White Syndrome / physiopathology