Association of Arrhythmia in Patients with Cervical Spondylosis: A Nationwide Population-Based Cohort Study.

Shih-Yi Lin,Cheng-Li Lin,Chia-Hung Kao,Der-Cherng Chen,Chih-Hsueh Lin,Chung-Y Hsu,Wu-Huei Hsu,Chun-Hao Tsai,Tsung-Chih Lin,Cheng-Chieh Lin

doi:10.3390/jcm7090236

Shih-Yi Lin, Cheng-Li Lin + Show 8 more

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https://doi.org/10.3390/jcm7090236

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Background: Sympathetic activity, including cervical ganglia, is involved in the development of cardiac arrhythmias. Objective: The present study investigated the association between cervical spondylosis and arrhythmia, which has never been reported before. Methods: Patients newly diagnosed with cervical spondylosis (CS) with an index date between 2000 and 2011 were identified from the National Health Insurance Research Database. We performed a 1:1 case-control matched analysis. Cases were matched to controls according to their estimated propensity scores, based on demographics and existing risk factors. Cox proportional hazard models were applied to assess the association between CS and arrhythmia. Results: The CS cohort comprised 22,236 patients (males, 42.6%; mean age, 54.4 years) and non-CS cohort comprised 22,236 matched controls. There were 1441 events of arrhythmia in CS cohort and 537 events of arrhythmia in non-CS cohort, which 252 and 127 events of atrial fibrillation in CS and non-CS cohort, 33 and 12 events of ventricular tachycardia in CS cohort and non-CS cohort, 78 and 35 events of supraventricular tachycardia in CS cohort and non-CS cohort. The CS cohort had an arrhythmia incidence of 11.1 per 1000 person-years and a higher risk [adjusted hazard ratio (aHR) = 3.10, 95% confidence interval (CI) = 2.80–3.42] of arrhythmia, 2.54-fold aHR of ventricular tachycardia (95% CI = 1.70–3.79), and 2.22-fold aHR of atrial fibrillation (95% CI = 1.79–2.76) compared with non-CS cohort. Conclusions: Cervical spondylosis is associated with a higher risk of arrhythmia.

Highlights

Arrhythmia is a potentially life-threatening condition; it is defined as an irregular heartbeat or abnormal heart rhythm [1]
The present study reveals that CS is associated with a 3.10-fold increase of arrhythmia risk compared to patients without cervical spondylosis, especially atrial fibrillation, ventricular and supraventricular tachycardia
Previous electrophysiological studies have demonstrated that sympathetic activation has a proarrhythmic effect in enhancing automaticity, triggering re-entry, and reducing the threshold of refractoriness [29,30,31]

Summary

Introduction

Arrhythmia is a potentially life-threatening condition; it is defined as an irregular heartbeat or abnormal heart rhythm [1]. Cardiac arrhythmia occurs in 11%–58% of the population, of which the most common type is atrial fibrillation [2]. Objective: The present study investigated the association between cervical spondylosis and arrhythmia, which has never been reported before. Results: The CS cohort comprised 22,236 patients (males, 42.6%; mean age, 54.4 years) and non-CS cohort comprised 22,236 matched controls. The CS cohort had an arrhythmia incidence of 11.1 per 1000 person-years and a higher risk [adjusted hazard ratio (aHR) = 3.10, 95% confidence interval (CI) = 2.80–3.42] of arrhythmia, 2.54-fold aHR of ventricular tachycardia (95% CI = 1.70–3.79), and 2.22-fold aHR of atrial fibrillation (95% CI = 1.79–2.76) compared with non-CS cohort. Conclusions: Cervical spondylosis is associated with a higher risk of arrhythmia

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