{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T21:26:33Z","timestamp":1772400393366,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T00:00:00Z","timestamp":1767398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Ankylosing spondylitis (AS) has been associated with various comorbidities, including cardiovascular morbidity. Recent studies suggest that certain arrhythmias may be more frequent in AS patients than in the general population. The aim of this study was to analyze the prevalence of electric heart disorders (EHD) in patients with AS in real-world conditions and compare them with those reported in the general population. Methods: Descriptive cross-sectional study aiming to determine the prevalence of EHD in AS in pre-COVID-19 period. EHD were analyzed in a resting ECG and 24 h Holter monitoring. Additionally, the association between clinical and demographic variables was analyzed. Results: Among 121 patients with AS (62% men; mean \u00b1 SD age 54.6 \u00b1 15.6 years; median [IQR] disease duration 14 (8\u201320) years), 18.2% presented any EHD, including 9.1% with supraventricular tachyarrhythmias (SVT) (5% atrial fibrillation [AF]) and 7.4% with atrioventricular block (AVB). Clinically relevant disorders (\u22652nd-degree AVB or SVT) were observed in 9.9% of patients. In adjusted analyses, SVT was independently associated with older age and higher BMI, while any conduction delay and clinically relevant EHD were associated with age, hypertension, and disease-modifying antirheumatic-drug treatment duration. Comparisons with previous population-based studies showed similar data, with a non-significant trend toward higher AF prevalence in AS patients. Conclusions: There appears to be a trend toward a higher prevalence of arrhythmias in patients with AS in real-world conditions, which could have clinical and therapeutic implications. An association between EHD and pro-inflammatory conditions such as age and BMI was observed, supporting the hypothesis that underlying inflammation might contribute to increased arrhythmogenicity.<\/jats:p>","DOI":"10.3390\/jcm15010362","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T10:53:50Z","timestamp":1767610430000},"page":"362","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cross-Sectional Study on Electrocardiographic Disorders in Patients with Ankylosing Spondylitis in Real-World Conditions"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8015-7192","authenticated-orcid":false,"given":"Carlos","family":"Rodr\u00edguez-L\u00f3pez","sequence":"first","affiliation":[{"name":"Cardiology Division, Hospital Universitario Pr\u00edncipe de Asturias, 28805 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7991-225X","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Soler Bonafont","sequence":"additional","affiliation":[{"name":"Internal Medicine Division, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-1986","authenticated-orcid":false,"given":"\u00c1lvaro","family":"Gamarra","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7661-651X","authenticated-orcid":false,"given":"Pablo","family":"D\u00edez-Villanueva","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5870-237X","authenticated-orcid":false,"given":"Luis Jes\u00fas","family":"Jim\u00e9nez-Borreguero","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2161-5421","authenticated-orcid":false,"given":"Miren","family":"Uriarte-Ecenarro","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6823-4194","authenticated-orcid":false,"given":"Esther F.","family":"Vicente-Rabaneda","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7924-7406","authenticated-orcid":false,"given":"Miguel A.","family":"Gonz\u00e1lez-Gay","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Department of Medicine, Universidad de Cantabria, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-2511","authenticated-orcid":false,"given":"Fernando","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7748-853X","authenticated-orcid":false,"given":"Santos","family":"Casta\u00f1eda","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Hospital Universitario de La Princesa, IIS-Princesa, 28006 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.5371\/hp.2017.29.4.211","article-title":"Diagnosis and treatment of inflammatory joint disease","volume":"29","author":"Kim","year":"2017","journal-title":"Hip Pelvis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s13075-016-1093-z","article-title":"Prevalence of peripheral and extra-articular disease in ankylosing spondylitis versus non-radiographic axial spondyloarthritis: A meta-analysis","volume":"18","author":"Baeten","year":"2016","journal-title":"Arthritis Res. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"427","DOI":"10.14740\/jocmr2488w","article-title":"Cardiac involvement in ankylosing spondylitis","volume":"8","author":"Ozkan","year":"2016","journal-title":"J. Clin. Med. Res."},{"key":"ref_4","first-page":"90","article-title":"Prevalence of rheumatic diseases in the adult population in Spain (EPISER 2016 study): Objectives and methodology","volume":"15","author":"Sivera","year":"2019","journal-title":"Reumatol. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1136\/annrheumdis-2013-204436","article-title":"Prevalence of spondyloarthritis in reference to HLA-B27 in the French population: Results of the GAZEL cohort","volume":"74","author":"Costantino","year":"2015","journal-title":"Ann. Rheum. Dis."},{"key":"ref_6","first-page":"338","article-title":"Characteristics of patients with spondyloarthritis followed in rheumatology units in Spain: emAR II study","volume":"8","year":"2012","journal-title":"Reumatol. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jaut.2014.01.015","article-title":"The classification and diagnostic criteria of ankylosing spondylitis","volume":"48\u201349","author":"Raychaudhuri","year":"2014","journal-title":"J. Autoimmun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1038\/s41430-021-00913-6","article-title":"Food groups associated with immune-mediated inflammatory diseases: A Mendelian randomization and disease severity study","volume":"75","author":"Tornero","year":"2021","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Mandour, M., Chen, S., and van de Sande, M.G.H. (2021). The role of the IL-23\/IL-17 axis in disease initiation in spondyloarthritis: Lessons learned from animal models. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.618581"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1056\/NEJMra1909094","article-title":"Reframing immune-mediated inflammatory diseases through signature cytokine hubs","volume":"385","author":"Schett","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e004187","DOI":"10.1136\/rmdopen-2024-004187","article-title":"Sex-specific impact of inflammation on traditional cardiovascular risk factors and atherosclerosis in axial spondyloarthritis: A multicentre study of 913 patients","volume":"10","author":"Genre","year":"2024","journal-title":"RMD Open"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.semarthrit.2014.12.002","article-title":"Cardiovascular morbidity and associated risk factors in Spanish patients with chronic inflammatory rheumatic diseases attending rheumatology clinics: Baseline data of the CARMA project","volume":"44","author":"Llorca","year":"2015","journal-title":"Semin Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.berh.2016.10.006","article-title":"Cardiovascular disease in inflammatory rheumatic diseases","volume":"30","author":"Nurmohamed","year":"2016","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1080\/08820139.2021.1884091","article-title":"The increased risk of atrial fibrillation in inflammatory arthritis: A systematic review and meta-analysis of cohort studies","volume":"51","author":"Ma","year":"2022","journal-title":"Immunol. Investig."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1093\/europace\/euac244","article-title":"Autoimmune diseases and new-onset atrial fibrillation: A UK Biobank study","volume":"25","author":"Tilly","year":"2023","journal-title":"Europace"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"262","DOI":"10.2174\/1381612824666180123102632","article-title":"Inflammatory arthritis and heart disease","volume":"24","year":"2018","journal-title":"Curr. Pharm. Des."},{"key":"ref_17","first-page":"1717","article-title":"Systemic inflammation and arrhythmic risk: Lessons from rheumatoid arthritis","volume":"38","author":"Lazzerini","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1253\/circj.CJ-15-0138","article-title":"Role of inflammation in atrial fibrillation pathophysiology and management","volume":"79","author":"Harada","year":"2015","journal-title":"Circ. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1136\/annrheumdis-2017-212189","article-title":"Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with the general population: A register-based study from Sweden","volume":"77","author":"Bengtsson","year":"2018","journal-title":"Ann. Rheum. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijcard.2018.10.024","article-title":"Ankylosing spondylitis: A novel risk factor for atrial fibrillation\u2014A nationwide population-based study","volume":"275","author":"Moon","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e150521193326","DOI":"10.2174\/1573403X17666210515164206","article-title":"Ankylosing spondylitis and risk of cardiac arrhythmia and conduction disorders: A systematic review and meta-analysis","volume":"17","author":"Morovatdar","year":"2021","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1136\/annrheumdis-2013-203934","article-title":"Tumour necrosis factor blocking agents and progression of subclinical atherosclerosis in patients with ankylosing spondylitis","volume":"74","author":"Peters","year":"2015","journal-title":"Ann. Rheum. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/art.1780270401","article-title":"Evaluation of diagnostic criteria for ankylosing spondylitis","volume":"27","author":"Valkenburg","year":"1984","journal-title":"Arthritis Rheum."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Rienstra","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"42","author":"GGlikson","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_26","first-page":"259","article-title":"Prevalence of atrial fibrillation in Spain: Results of the OFRECE study","volume":"67","author":"Lobos","year":"2014","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/eurheartj\/eht176","article-title":"Prognostic significance of prolonged PR interval in the general population","volume":"35","author":"Aro","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"860651","DOI":"10.1155\/2014\/860651","article-title":"Adipokines, biomarkers of endothelial activation, and metabolic syndrome in patients with ankylosing spondylitis","volume":"2014","author":"Genre","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1002\/oby.21945","article-title":"Association between peripheral adipokines and inflammation markers: A systematic review and meta-analysis","volume":"25","author":"Wirsching","year":"2017","journal-title":"Obesity"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/1756-185X.12958","article-title":"Inflammation, metabolism and adipokines: Toward a unified theory","volume":"19","author":"Viswanath","year":"2016","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1007\/s10067-025-07426-8","article-title":"Association of regional adiposity distribution with risk of autoimmune diseases","volume":"44","author":"Fan","year":"2025","journal-title":"Clin. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1002\/art.42613","article-title":"Body mass index and the risk of rheumatic disease: Linear and nonlinear Mendelian randomization analyses","volume":"75","author":"Karlsson","year":"2023","journal-title":"Arthritis Rheumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1373\/clinchem.2016.255182","article-title":"Application of biomarkers for risk stratification in patients with atrial fibrillation","volume":"63","author":"Hijazi","year":"2017","journal-title":"Clin. Chem."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1177\/0003319717709380","article-title":"Systemic inflammation and arrhythmogenesis: A review of mechanistic and clinical perspectives","volume":"69","author":"Yalta","year":"2018","journal-title":"Angiology"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Rea, I.M., Gibson, D.S., McGilligan, V., McNerlan, S.E., Alexander, H.D., and Ross, O.A. (2018). Age and age-related diseases: Role of inflammation triggers and cytokines. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00586"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.acvd.2015.01.009","article-title":"Type 2 diabetes mellitus and atrial fibrillation: From mechanisms to clinical practice","volume":"108","author":"Tadic","year":"2015","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/5584_2017_41","article-title":"Cardiac arrhythmias in patients with exacerbation of COPD","volume":"1022","author":"Rusinowicz","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"ITC33","DOI":"10.7326\/AITC201703070","article-title":"Atrial fibrillation","volume":"166","author":"Zimetbaum","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1002\/joa3.12405","article-title":"Cardiac arrhythmias in patients with COVID-19","volume":"36","author":"Wang","year":"2020","journal-title":"J. Arrhythm."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e449","DOI":"10.1161\/CIR.0000000000001290","article-title":"Cardiac arrhythmias and autonomic dysfunction associated with COVID-19: A scientific statement from the American Heart Association","volume":"150","author":"Gopinathannair","year":"2024","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1136\/heartjnl-2015-308956","article-title":"Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: A systematic review and meta-analysis","volume":"102","author":"Kwok","year":"2016","journal-title":"Heart"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/362\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:12:47Z","timestamp":1767611567000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/362"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,3]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15010362"],"URL":"https:\/\/doi.org\/10.3390\/jcm15010362","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,3]]}}}