{
  "abstract": "Background Steatotic liver disease (SLD) is independently associated with cardiovascular disease, but data on cardiac arrhythmias across individual SLD subtypes remain scarce. This study aims to evaluate associations between SLD subtypes and arrhythmia risk.Methods The prospective cohort utilized data from the UK Biobank. Participants were categorized into no-SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD), and alcohol-associated liver disease (ALD). The primary outcome was the incidence of overall arrhythmias, with secondary outcomes examining specific arrhythmia subtypes. Associations were examined using multivariable-adjusted Cox proportional hazards models, and exploratory analyses assessed potential etiologic contributions.Results Among 428,609 participants followed for a median of 14.23 years, the incidence of arrhythmias increased progressively from no-SLD to MASLD, MetALD, and ALD (8.22%, 13.60%, 14.15%, and 16.43%, respectively) ( IDDF2026-ABS-0364 Figure 1. Population distribution and incidence of arrhythmias by SLD subtypes). All SLD subtypes were independently associated with a higher risk of overall arrhythmias (MASLD: aHR 1.18, 95% CI 1.15-1.21; MetALD: aHR 1.20, 95% CI 1.16-1.25; ALD: aHR 1.32, 95% CI 1.25-1.39; all P<0.001). Tachyarrhythmias and bradyarrhythmias exhibit distinct and specific associations with SLD subtypes (IDDF2026-ABS-0364 Figure 2. Arrhythmia subtypes and cumulative incidence by SLD subtypes). Atrial fibrillation and flutter (AF/AFL), the most common tachyarrhythmia, accounted for 85.39% of arrhythmic events. AF/AFL risk increased stepwise across SLD subcategories, with aHRs of 1.28 (95% CI 1.24–1.33) for MASLD, 1.34 (95% CI 1.28–1.41) for MetALD, and 1.57 (95% CI 1.48–1.68) for ALD (all P<0.001) (IDDF2026-ABS-0364 Figure 3. Tachyarrhythmia subtypes and cumulative incidence by SLD subtypes). Conversely, only MASLD (aHR 1.09, 95% CI 1.02–1.16; P=0.013) and MetALD (aHR 1.12, 95% CI 1.02–1.23; P=0.013) were associated with higher bradyarrhythmia risk. First-degree atrioventricular block, the predominant bradyarrhythmia (51.84% of cases), showed the same pattern of association (IDDF2026-ABS-0364 Figure 4. Bradyarrhythmia subtypes and cumulative incidence by SLD subtypes). Etiologic analyses indicated that alcohol contributed more strongly to tachyarrhythmia than to bradyarrhythmia risk.Conclusions SLD is independently associated with incident arrhythmias, with AF/AFL risk increasing across the MASLD–MetALD–ALD spectrum. The risk of bradyarrhythmias is largely confined to metabolically driven subtypes. Alcohol and metabolic dysfunction were both associated with increased tachyarrhythmia risk; in contrast, bradyarrhythmia risk is primarily associated with metabolic factors. These findings support subtype-specific arrhythmia surveillance and heart–liver co-management strategies in clinical practice.Abstract IDDF2026-ABS-0364 Figure 1Abstract IDDF2026-ABS-0364 Figure 2Abstract IDDF2026-ABS-0364 Figure 3Abstract IDDF2026-ABS-0364 Figure 4",
  "authors": [
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Ya Lin"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Xiao-dong Zhou"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Ming-hua Zheng"
    }
  ],
  "title": "IDDF2026-ABS-0364 Steatotic liver disease subtypes exhibit distinct risk patterns of tachyarrhythmias and bradyarrhythmias",
  "uid": "a5890066-f186-518d-99d9-9fca6af0e016"
}