Temporal associations between severe infection and long-term risk of incident arrhythmias: a population-based cohort study
In brief
Severe infection linked to 11-fold higher arrhythmia risk in the first month
Among 465,374 UK Biobank participants, severe infection was linked to an 11-fold higher risk of arrhythmia in the first 30 days, with risk still 58% higher after a year. Recurrent infections and sepsis were linked to greater risk, but infection history adds only modest information beyond traditional risk factors, and the study cannot establish cause and effect.
- Journal
- BMC medicine (Q1)
- Published
- 4 August 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Hai Deng, Mei-Ping Lin, Xin-Yan He, Min-Jing Huang, Si-Long Lu, Jin-Bo Fu, et al.
- PMID
- 42972595
- DOI
- 10.1186/s12916-026-05098-y
Why clinicians should know about it
- Picked for Epidemiology (top studies of the week, 8 November 2026): Large validated cohorts examine infection timing, recurrence, and arrhythmia risk
Abstract
BACKGROUND: The long-term impact of severe infection on arrhythmia risk across the cardiac rhythm spectrum remains incompletely characterized. We investigated the association between hospital-treated infection and incident arrhythmias, examining temporal patterns, pathogen and site specificity, and cumulative effects. METHODS: We conducted a prospective analysis of 465,374 UK Biobank participants. Time-dependent Cox proportional hazards models were adjusted for sociodemographic factors, lifestyle behaviors, clinical comorbidities, and biochemical parameters. Comprehensive analyses assessed infection timing (1-30, 31-365, ≥366 days), type (bacterial, viral, sepsis), site, and recurrence. Findings were validated in ARIC and CHS cohorts. RESULTS: Over a median follow-up of 14.2 years, 70,527 (15.2%) participants had a severe infection. Infection was associated with a significantly increased risk of any incident arrhythmia (adjusted HR 1.85, 95% CI 1.80-1.90). Risks were elevated across all specific arrhythmias, being particularly pronounced for sudden cardiac arrest (HR 2.79, 2.54-3.07), ventricular arrhythmias (HR 3.11, 2.80-3.45), and AV block (HR 3.03, 2.83-3.25). Risk demonstrated temporal gradient, peaking at 1-30 days (HR 11.40, 10.44-12.47 for any arrhythmia) and remaining elevated long-term (HR 1.58, 1.53-1.63 at ≥366 days). Sepsis posed the highest risk among infection types, while pneumonia was most hazardous among sites. Recurrent infections showed a dose-response relationship, with second infections conferring greater risk than first infections (HR 2.51 vs 1.85). Population attributable fractions for infection reached 16.6% for AV block, comparable to traditional risk factors. External validation confirmed these associations. CONCLUSION: Severe infection is associated with increased long-term risks of various arrhythmias, with variations by time since infection, infection characteristics, and recurrence history. These observations suggest that a history of severe infection may provide modest additional information for arrhythmia risk assessment, though its contribution is substantially smaller than that of traditional risk factors such as hypertension.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.