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Abnormal ECG findings seen in psoriatic arthritis patients

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Results of a case-control study suggest that psoriatic arthritis patients may have “subtle” cardiac conduction disturbances.

“In surveying the literature, scant data were found regarding cardiac arrhythmias in psoriatic arthritis patients,” the study team notes in the December issue of the Journal of Rheumatology.

Therefore, Dr. Devy Zisman from Carmel Medical Center, Haifa, Israel and colleagues compared the electrocardiogram scans of 92 patients with psoriatic arthritis to those of 92 age- and sex-matched nonpsoriatic, nonarthritic control subjects.

“The major finding of our study,” they report, “is a statistically significantly longer PR interval in the patients with psoriatic arthritis compared to individuals without psoriasis or arthritis” (159.6 vs 151.3 milliseconds, respectively; p = 0.021). Compared with controls, the mean PR interval was 8.3 milliseconds, 5.5% longer, in patients with psoriatic arthritis.

“Although the clinical relevance of this finding is questionable since the absolute difference was small, the importance of the observation is the implication of atrioventricular node involvement in the psoriatic arthritis systemic disease,” Dr. Zisman and colleagues note.

The abnormal prolongation of the PR interval was asymptomatic, requiring no additional intervention. No statistical difference was apparent with respect to the QRS interval or other ventricular conduction disturbances studied.

There was no apparent effect of methotrexate or nonsteroidal anti-inflammatory drug therapy on the cardiac conduction properties examined; the effects of the newer biological treatments were not assessed in this study.

Dr. Zisman and colleagues conclude, based on their observations that “a prospective study with prolonged followup is warranted to elucidate the clinical significance of our observed conduction abnormalities.”

J Rheumatol 2008;35:2379-2382.