Background: Inflammatory bowel diseases (IBD) associated-chronic inflammation and autonomic dysregulation may predispose to arrhythmias. However, its exact prevalence is unknown. Thus, we aimed to ascertain the prevalence of arrhythmias in patients with IBD. Methods: We queried the Nationwide Inpatient Sample (the largest publicly available all-payer inpatient USA database) from 2012 to 2014. We used the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) discharge codes to identify adult patients (⩾18 years) with IBD and dysrhythmias (supraventricular tachycardia (SVT), atrial fibrillation, atrial flutter, ventricular tachycardia (VT), or ventricular fibrillation). Furthermore, we identified risk factors for cardiovascular disease. We divided patients into 2 cohorts, IBD cohorts, and non-IBD cohort. The independent effect of a diagnosis of IBD on the risk of dysrhythmias was examined using a multivariable logistic regression model controlling for multiple confounders. Results: We identified 847 235 and 84 757 349 weighted hospitalizations among patients with IBD and non-IBD cohorts, respectively. Patients with IBD were less likely to be hospitalized for dysrhythmias than the non-IBD (9.7% vs 14.2%, P < .001). The hospitalization odds for dysrhythmias among patients with IBD were less than the general population (OR 0.87; 95% CI 0.85-0.88). However, the prevalence of SVT and VT was indifferent between the 2 groups. Male sex, age of over 60, and white race were risk factors for dysrhythmias. Conclusion: Despite prior reports of a higher prevalence of arrhythmias among patients with IBD, in a nationwide inpatient database, we found lower rates of hospitalization-related-arrhythmias in the IBD population compared to that of the general population.

The incidence of Lyme disease in the USA is 8 per 100 000 cases and 95% of those occur in the Northeastern region. Cardiac involvement occurs in only 1% of untreated patients. We describe the case of a 46-year-old man who presented with chest pressure, dyspnoea, palpitations and syncope. He presented initially with atrial fibrillation with rapid ventricular response, a rare manifestation of Lyme carditis. In another hospital presentation, he had varying degrees of atrioventricular block including Mobitz I second-degree heart block. After appropriate antibiotic treatment, he made a full recovery and his ECG normalised. The authors aim to urge physicians treating patients in endemic areas to consider Lyme carditis in the workup for patients with atrial fibrillation and unexplained heart block, as the associated atrioventricular nodal complications may be fatal.

Introduction: A growing evidence depicted the role of systemic inflammation in the pathogenesis of cardiac Arrhythmias (CA). However, uncertainty remains as to the exact relationship between Inflammatory Bowel Disease (IBD) and CA. So far, most of the studies had centered on the implication of inflammatory mechanisms in the development of atrial fibrillation (AF) in IBD. The association between IBD and other arrhythmias is not well elucidated. Hypothesis: We hypothesized that IBD might be associated with a higher burden of CA. Methods: We queried the national inpatient sample (NIS) from 2012 to 2014. Discharges associated with IBD (Chron's or ulcerative colitis), cardiac arrhythmias including AF, Atrial flutter, SVT, VT, VF were identified using ICD-9-CM codes 555.xx, 556.xx, 427.3, 427.32, 427.0, 427.1, 427.41, respectively. We divided patients into two groups, IBD Vs. Non-IBD. Outcomes are the prevalence of CA (AF, A.flutter, SVT, VT, V.fib) amongst both groups, as well as the correlation between CA and demographic of patient cohorts. Multivariable logistic regression (MLR) was utilized to adjust for differences in baseline characteristics. Results: We identified 847,235 weighted hospitalizations among patients with IBD and 84,757,349 hospitalizations among the general population, ≥18 years of age. Overall, IBD patients were less likely to be admitted with cardiac arrhythmias than the non-IBD population (9.7% versus 14.2%, P, <0.001). On MLR, IBD Group had lower odds of CA during hospitalization (OR, 0.87; 95% CI 0.85-0.88), AF (OR, 086; 95%CI 0.85-0.88) A.flutter (OR,0.78; 95% CI 0.74-0.83), VF (OR, 0.69; 95% CI 0.59-0.79). While the prevalence of SVT and VT was not different between the two groups. Male sex, age of more than 60 years, and white Race were risk factors for Arrhythmias. Conclusions: In conclusion NIS analysis revealed lower rates of hospitalization-associated arrhythmias in the IBD population compared to the general population.

Levofloxacin is a fluoroquinolone antibiotic which is used widely in treating various infections. Despite this benefit, Levofloxacin has a cardiac side effect called drug-induced long QT syndrome (diLQTS), which is associated with Torsades de Pointes (TdP). In this study, our objective was to analyze the incidence of diLQTS associated with Levofloxacin use in Ahmad Dahlan Hospital Kediri. This study included patients who were admitted to Ahmad Dahlan Hospital Kediri from March-May 2019 and received Levofloxacin 500mg therapy once daily. An electrocardiogram was performed before and after initiation of therapy. Prolonged QTc was defined by heart rate-corrected QT ≥450ms for male and ≥470ms for female, calculated using Bazett formula; or if the prolongation of QT interval is >60ms from baseline. Acquired data were analyzed using Paired T-test. Of all 24 patients who received Levofloxacin, six patients developed long QTc. Two of which had >60ms difference from base ECG (p-value >0.05). No symptom of TdP was reported. The incidence of diLQTS associated with Levofloxacin use was 25%. Risk factor stratification and ECG monitoring should be done from the beginning of the therapy.

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