The Association of Arterial Stiffness With the High Incidence of Cardiac Arrhythmias in Patients With Peripheral Arterial Disease

The purpose of the study was to identify the incidence and type of arrhythmias and their relationship to the vascular abnormalities in a cross sectional study of 110 patients with peripheral artery disease (PAD). Cardiac arrhythmias were found in 37% of the PAD subjects. Frequent premature ventricular and supraventricular contractions were the most common arrhythmias (78%) and most (65%) were observed at rest. PR segment duration, QRS complex duration and QTc interval were significantly longer in patients with arrhythmias. QTc differences were significant only for males. Both initial and absolute claudication distances were greater in patients with arrhythmias but ankle/brachial index values were not. For comparison, arrhythmias were monitored in a patients (n=111) with coronary artery disease (CAD) but without PAD. Cardiac arrhythmias were observed in 29% of this population. Age (>60 years), pre-existing CAD and greater arterial stiffness (as determined by significantly higher augmentation index values during pulse wave analysis (PWA)) were identified as predictors of arrhythmias in PAD patients. In conclusion, patients with PAD have a high incidence of cardiac arrhythmias at rest. Older age, concomitant CAD and greater arterial stiffness may pre-dispose PAD patients to arrhythmias. A simple, non-invasive technique like PWA may allow for risk stratification.