Spondylitis and Arrythmia

[Frank__0]

  I have recently been diagnosed with an irregular heartbeat and have been examined by a cardiac physician who said that the condition was benign.  I also suffer from spondylitis.  I recently read that ankolysing spondylitis can cause the heart to beat irregularly.  I don't know if my spondylitis is categorized as ankolylising but do you know of any connection between this or other forms of spondylitis and irregular heartbeat.  Thank you.

[CCF Cardio MD - MTR]

Dear Frank, thank you for your question. I was able to do a computerized search of the medical literature for you on this subject.  I found that there is an association between arrhythmias (irregular heartbeats) and anklyosing spondylitis.  I've copied a few of the abstracts for you and attached them to this response below.  You could get copies of these articles at your nearest medical library.  If you have concerns regarding your irregular heartbeat, then I suggest that you speak with your cardiologist again.
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Unique Identifier
88308053
Authors
Alves MG.  Espirito-Santo J.  Queiroz MV.  Madeira H.  Macieira-Coelho E.
Institution
Department of Cardiology, Sta. Maria University Hospital, Lisbon, Portugal.
Title
Cardiac alterations in ankylosing spondylitis.
Source
Angiology.  39(7 Pt 1):567-71, 1988 Jul.
Local Messages
Abstract
Forty patients, 30 men and 10 women with an average age of 38.47 +/- 11.07 years, suffering from ankylosing spondylitis and attending a Rheumatology Outpatient Clinic, were evaluated for cardiovascular involvement. The evaluation was based on patients' clinical observation, electrocardiography, echocardiography, and chest x-ray. More than a simple review, this study was undertaken with the aim of arriving at a better clinical definition of the cardiovascular manifestations found in ankylosing spondylitis. In fact, of the 40 patients, 8 (20%) had systemic hypertension for which an explanation could not be found, 4 of whom were less than forty-five years old; the echocardiogram showed mitral valve prolapse in 4 patients (10%), 2 of them with a systolic murmur and other 2 with a protosystolic click on auscultation. More significant than the changes in conduction was the finding of a sinus bradycardia in 9 patients (22.5%), and a PR interval below 120 msec in 3 patients (7.5%). The authors conclude that the extension of cardiovascular changes in ankylosing spondylitis is more vast than usually acknowledged.

Unique Identifier
88282927
Authors
Nagyhegyi G.  Nadas I.  Banyai F.  Luzsa G.  Geher P.  Molnar J.  Velics V.  Gomor B.  Weisz M.  Antaloczy Z.
Institution
National Institute of Rheumatology and Physiotherapy, Budapest Postgraduate Medical University, Hungary.
Title
Cardiac and cardiopulmonary disorders in patients with ankylosing spondylitis and rheumatoid arthritis.
Source
Clinical & Experimental Rheumatology.  6(1):17-26, 1988 Jan-Mar.
Abstract
One hundred patients suffering from ankylosing spondylitis (AS) and one hundred patients suffering from rheumatoid arthritis (RA) were examined by clinical, non-invasive cardiological, radiological and laboratory methods to determine the prevalence of their cardiac and cardiopulmonary disorders. Fourteen patients with AS and 24 patients with RA had several valvular abnormalities. Among the patients not having any valvular abnormality, systolic dysfunction of the myocardium was detectable in 15 and 11 cases respectively, and cor pulmonale was diagnosed in 16 and 7 cases respectively. Conduction disturbances were demonstrated in 17 patients suffering from AS and in 14 patients suffering from RA.
Unique Identifier
82281440
Authors
Bergfeldt L.  Edhag O.  Vedin L.  Vallin H.
Title
Ankylosing spondylitis: an important cause of severe disturbances of the cardiac conduction system. Prevalence among 223 pacemaker-treated men.
Source
American Journal of Medicine.  73(2):187-91, 1982 Aug.
Abstract
The cause of severe disturbances of the cardiac conduction system is seldom possible to establish clinically at pacemaker implantation, apart from cases of acute myocardial infarction or digitalis intoxication and in relatively rare cases of inflammatory disorders such as sarcoidosis and systemic sclerosis. Since cardiac manifestations, mainly conduction disturbances, occur in patients with ankylosing spondylitis, the prevalence of this disease was determined using radiologic screening for sacroiliitis in a population of 223 men who had permanently implanted pacemakers. Sacroiliitis was found in 19 men (8.5 percent), 15 of whom fulfilled the diagnostic criteria for ankylosing spondylitis. In six patients, sacroiliitis was asymptomatic and two of the patients were completely free of symptoms other than those originating from their heart manifestations. In seven of the 15 patients with ankylosing spondylitis and in the four patients with sacroiliitis without clinical criteria of ankylosing spondylitis, the diagnosis was previously unknown. Uveitis and aortic regurgitation occurred in five patients each, while peripheral arthritis was twice as common. The prevalence of sacroiliitis and ankylosing spondylitis of 8.5 and 6.7 percent, respectively, differ significantly (p less than 0.01) from the frequencies found in general Caucasian populations of 1 to 2 and 0.1 to 0.5 percent, respectively. HLA B27 was present in more than 80 percent of the patients with sacroiliitis and/or ankylosing spondylitis, compared with 8 to 10 percent in the general population. This strong association is in accordance with previous studies of patients with symptomatic sacroiliitis and/or ankylosing spondylitis. Thus sacroiliitis, diagnosed by x-ray, can be considered a marker for this relatively common rheumatic cause of severe disturbances of the cardiac conduction system.