title: Paroxysmal supraventricular tachycardia and Wolff-Parkinson-White syndrome in ankylosing spondylitis: a large cohort observation study and literature review.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Medicine, Division of Allergy, Immunology, and Rheumatology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Huei-Huang
authors.initials: HH
authors.lastname: Ho
authors.forename: San-Jou
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Wen-Pin
authors.initials: WP
authors.lastname: Tsai
authors.forename: Chin-Man
authors.initials: CM
authors.lastname: Wang
authors.forename: Ji Yih
authors.initials: JY
authors.lastname: Chen
mesh_terms: D000328:Adult; D015897:Comorbidity; D004244:Dizziness / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004417:Dyspnea / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013575:Syncope / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology