ARRHYTHMIAS DEVELOPING DURING ACUTE RHEUMATIC FEVER: A LONG-TERM SINGLE CENTRE EXPERIENCE

Objective: This study aimed to evaluate the prevalence, types, and clinical significance of arrhythmias observed during acute rheumatic fever (ARF) episodes and their association with the severity of carditis in a single centre paediatric cohort. Material and Methods: A retrospective review of medical records from 118 patients diagnosed with ARF based on the revised Jones criteria was performed. Electrocardiograms (ECGs) recorded during the acute phase were analysed for arrhythmias, including atrioventricular (AV) blocks, supraventricular and ventricular arrhythmias, and conduction disturbances. Patients were stratified into mild-moderate and severe carditis groups. Statistical analyses were conducted using SPSS 26.0, with p-values<0.05 considered significant. Results: Among the 118 patients (mean age 10.5±1.7 years; 55% female), 51.6% exhibited first-degree AV block. The other arrhythmias included second-degree AV block (4.2%), complete AV block (0.8%), supraventricular tachycardia (0.8%), non-sustained ventricular tachycardia (0.8%), and junctional rhythm (1.7%). Supraventricular and ventricular extrasystoles were identified in 4.2% and 5.9% of the patients, respectively. Most arrhythmias occurred in the mild-to-moderate carditis group and resolved spontaneously or with minimal intervention. No arrhythmias were associated with mortality or long-term complications. Conclusion: Arrhythmias during ARF are relatively uncommon but may reflect myocardial inflammation. While typically benign and self-limiting, vigilant monitoring is essential for timely management. Further research is needed to elucidate the underlying mechanisms and optimise treatment strategies for arrhythmias in ARF.