Ungurean Veronica, Costan Diana Elena, Dobos Monica Claudia, Ouatu Anca, Morariu Paula Cristina, Oancea Alexandru Florinel, Godun Maria Mihaela, Floria Diana-Elena, Marcu Dragos Traian, Baroi Genoveva Livia, Stanciu Silviu Marcel, Knieling Anton, Tanase Daniela Maria, Ancuta Codrina, Floria Mariana
Department of Medical Sciences II, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Rheumatology, Clinic Rehabilitation Hospital, 700661 Iasi, Romania.
Life (Basel). 2025 Sep 11;15(9):1426. doi: 10.3390/life15091426.
Rheumatoid arthritis is the most prevalent systemic inflammatory disease, mainly affecting the synovial tissue of small and large joints, also associated with significant extra-articular manifestations. Throughout the progression of the disease, cardiac structures may be affected, including the conducting system, myocardium, endocardium, coronary arteries, and valves, potentially resulting in a higher incidence of cardiac arrhythmias.
We performed a narrative review of the most recent studies that highlight the epidemiology, pathophysiology, diagnosis, and management of arrhythmias occurring in patients with rheumatoid arthritis. Furthermore, we examined the impact of disease-modifying antirheumatic drugs (DMARDs)-including conventional synthetic (csDMARDs), biologic (bDMARDs), and targeted synthetic agents (tsDMARDs)-on cardiac electrophysiology.
Cardiac immune cells may influence arrhythmogenesis through non-canonical and inflammatory mechanisms by modifying myocardial tissue architecture or by interacting with cardiomyocytes, potentially altering their electrical function.
This review emphasizes the essential role of a multidisciplinary approach integrating rheumatology and cardiology expertise in the screening and management of arrhythmias in patients with rheumatoid arthritis.
类风湿关节炎是最常见的全身性炎症性疾病，主要影响大小关节的滑膜组织，也伴有明显的关节外表现。在疾病的整个进展过程中，心脏结构可能会受到影响，包括传导系统、心肌、心内膜、冠状动脉和瓣膜，这可能导致心律失常的发生率更高。
我们对最近的研究进行了叙述性综述，这些研究突出了类风湿关节炎患者发生心律失常的流行病学、病理生理学、诊断和管理。此外，我们研究了改善病情抗风湿药物（DMARDs）——包括传统合成药物（csDMARDs）、生物制剂（bDMARDs）和靶向合成药物（tsDMARDs）——对心脏电生理的影响。
心脏免疫细胞可能通过非经典和炎症机制影响心律失常的发生，这些机制包括改变心肌组织结构或与心肌细胞相互作用，从而可能改变其电功能。
本综述强调了在类风湿关节炎患者心律失常的筛查和管理中，整合风湿病学和心脏病学专业知识的多学科方法的重要作用。
