Predictors of Cardiac Arrhythmia in Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized primarily by persistent synovial inflammation and progressive joint destruction. In addition to musculoskeletal manifestations, patients with RA have an increased risk of cardiovascular morbidity and mortality compared with the general population. Cardiac arrhythmias represent one of the important cardiovascular complications in these patients and may contribute to sudden cardiac death Electrocardiographic markers reflecting abnormalities in atrial and ventricular depolarization and repolarization have gained increasing attention as predictors of arrhythmogenic risk. QT dispersion (QTd) reflects heterogeneity of ventricular repolarization and has been associated with ventricular arrhythmias. P-wave dispersion (PWD) represents inhomogeneous atrial conduction and is considered a predictor of atrial arrhythmias, particularly atrial fibrillation. Tp-e interval and Tp-e dispersion are relatively newer markers reflecting transmural dispersion of ventricular repolarization and have been linked to malignant ventricular arrhythmias Chronic inflammation, autonomic dysfunction, endothelial dysfunction and myocardial involvement in rheumatoid arthritis may contribute to abnormalities in these electrocardiographic parameters. Early identification of patients at higher risk of cardiac arrhythmias may improve risk stratification and allow timely intervention. Therefore, the present study aims to evaluate QT dispersion, P-wave dispersion and Tp-e dispersion as predictors of cardiac arrhythmias in patients with rheumatoid arthritis

Inclusion criteria

• Patients diagnosed with rheumatoid arthritis according to the 2010 ACR/EULAR classification criteria
• Age ≥18 years
• Male and female patients

Exclusion criteria

• Presence of other autoimmune diseases
• Thyroid disorders
• Use of medications affecting cardiac conduction or repolarization such as amiodarone and other antiarrhythmic drugs
• Electrolyte disturbances including hypocalcemia, hypokalemia and hypomagnesemia
• Known cardiac diseases including ischemic heart disease, valvular heart disease, cardiomyopathy, heart failure or congenital heart disease