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