Causal relationship between schizophrenia and tachyarrhythmia: A Mendelian randomization study based on a European population

Given the emerging evidence suggesting a link between schizophrenia (SCZ) and tachyarrhythmias, this study utilized a bidirectional Mendelian randomization (MR) approach to explore the causal relationship between SCZ and several common tachyarrhythmias, including tachycardia, atrial flutter (AFL), atrial fibrillation (AF), and supraventricular tachycardia (SVT). Stringent selection criteria were applied to identify instrumental variables, followed by 5 MR analyses grounded in different hypotheses to evaluate the causal relationship between SCZ and tachycardia, SVT, and "AFL and AF." Inverse variance weighted (IVW) was the primary MR analysis method used. Additionally, several sensitivity analyses were performed, including the MR pleiotropy residual sum and outlier global test, Cochran Q test, MR-Egger intercept test, leave-one-out sensitivity analysis, and bias risk assessment. The bidirectional MR analysis revealed that SCZ is a risk factor for both SVT and "AFL and AF." Specifically, SCZ was found to significantly impact SVT [PIVW = .038, odds ratio = 1.001, 95% confidence interval: 1.000-1.002] and "AFL and AF" (PIVW = .005, odds ratio = 1.001, 95% confidence interval: 1.000-1.002). All studies were free of significant pleiotropy as well as genetic heterogeneity, the results of the studies were independent of individual genetic variant, and the selection of instrumental variables was unbiased. In a bidirectional MR analysis, we found that SCZ is a risk factor for SVT as well as "AFL and AF," and that early intervention in patients with SCZ associated with tachyarrhythmias may be the key to improving their survival.