Ankylosing spondylitis and atrial fibrillation: a contemporary overview

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and it is associated with increased morbidity and mortality. AF is linked with inflammatory signalling while inflammation and oxidative stress promote atrial remodelling, favouring the development and perpetuation of the arrhythmia. On the other hand, ankylosing spondylitis (AS) is considered a chronic inflammatory rheumatic condition with flares and remissions that affects the axial skeleton and mainly young people. AS has been associated with an increased risk of valvular and aorta disease but its relationship with AF has not been studied well. Recent epidemiological evidence indicates an association between AS and AF. This brief review provides a concise overview of all available data regarding the association between AS and AF including the predictive role of electrocardiographic and echocardiographic markers. Several unresolved issues including the thromboembolic risk in this setting and the potential role of anti-inflammatory interventions are also discussed.