We investigated the electrophysiological properties of the heart in patients with definite or classical rheumatoid arthritis using programmed electrical stimulation techniques. Twelve patients with rheumatoid arthritis and without evidence of organic heart disease or arrhythmia detectable with serial electrocardiograms and 24-hour ambulatory electrocardiographic monitoring were compared with 12 control subjects. Stimulation was performed from the high right atrium and right ventricular apex at a drive cycle length of 600 msec and the recording sites included high right atrium, atrioventricular junction and distal coronary sinus. There was no statistically significant difference in the corrected sinus node recovery time between the study and control group of patients. Similarly, no differences from normal were found in the AH and HV intervals or in the atrial and ventricular refractoriness, whereas the atrioventricular nodal effective refractory period was higher in patients with rheumatoid arthritis, compared with the control group (338 +/- 38 vs 286 +/- 29, P less than 0.02). The atrial conduction time during basic cycle length had a tendency to increase from high right atrium to atrioventricular junction in the study group and reached statistical significance from high right atrium to coronary sinus (92 +/- 15 vs 74 +/- 14, P less than 0.05). Electrophysiologic differences between the study and control patients also included a greater increase in maximal intraatrial (40 +/- 13 vs 27 +/- 16, P less than 0.05) and interatrial conduction delay (54 +/- 16 vs 31 +/- 12, P less than 0.01) of early premature stimuli in patients with rheumatoid arthritis.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult Arthritis, Rheumatoid