Objectives: It has been reported that increased sempathic nerve system activity due to infalammatory stress and it cause disturbance of heart rate variability (HRV) in rheumatoid arthritis (RA). In this study, it was assessed cardiac sempatovagal activity by noninvasive parameters such as HRV in patients with RA.Materials and methods: 49 patients with RA and age-matched 28 healthy subjects as control group were enrolled to this study. Clinical and laboratory parameters of all subjects were assessed and 24-hour electrocardiographic Holter monitoring were performed to all of them.Results: Minimum, maximum and mean heart rate were significantly higher while mean RR interval were significantly lower in patients with RA when compared with controls. In addition, among time domain HRV parameters, SDNN, SDANN ve triangular index were significantly lower in patients with RA (p<0.05, p<0.01, p<0.01, respectively). In correlation analysis, it was not found a significant association between HRV parameters and age, sex, duration and activity of disease, inflammatory markers, supraventricular or ventricular extrasystole (VES). There were only significant negative associations between VES and pNN50, SDANN and RMSDD. But, there was no independent correlation between these parameters.Conclusion: Non-invasive parameters such as HRV may have a modest role in assessment of cardiovascular risk and prediction of sudden cardiac death risk, in addition to the traditional risk factors, in patients with RA. However, to reach to the more accurate decision, there are need to carry out larger and long term studies which include different patients groups