Arrhythmogenic Implications of Inflammatory Bowel Disease: Its Mechanisms and Treatment Effects

TL;DR

Inflammatory bowel disease is linked to heart rhythm problems, and this review explores the mechanisms and treatment effects.

Contribution

This review integrates clinical and mechanistic insights into the arrhythmia risk associated with inflammatory bowel disease.

Findings

Elevated incidence of atrial fibrillation and conduction abnormalities in inflammatory bowel disease patients.

Systemic cytokine activation and autonomic dysfunction mediate the link between inflammation and arrhythmias.

Biologic agents generally show cardiac safety, while corticosteroids have dose-dependent cardiovascular effects.

Abstract

Inflammatory bowel disease, comprising Crohn’s disease and ulcerative colitis, is increasingly recognized as a systemic condition that extends beyond the gastrointestinal tract. Growing evidence indicates a significant association between inflammatory bowel disease and cardiovascular complications, particularly cardiac arrhythmias, driven by persistent inflammation and, in some cases, medication effects. This review integrates current clinical and mechanistic insights into the link between inflammatory bowel disease and arrhythmia risk. Recent epidemiological and genetic studies consistently show an elevated incidence of atrial fibrillation, atrioventricular block, and other conduction abnormalities in affected patients, independent of traditional cardiovascular risk factors. Systemic cytokine activation, autonomic dysfunction, and structural cardiac remodeling appear to be central mediators. Drug effects vary, with aminosalicylates occasionally causing reversible myocarditis, corticosteroids producing dose and duration-related cardiovascular effects, and biologic agents generally demonstrating cardiac safety. Recognizing these associations highlights the importance of comprehensive cardiovascular assessment and inflammation control in patient care. Coordinated multidisciplinary management and long-term research are essential to refine risk prediction and improve cardiac outcomes in this population.

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