COVID-19 BBIBP-CorV vaccine and transient heart block – A phenomenon by chance or a possible correlation – A case report. (November 2021)

• Record Type: Journal Article
• Authors: Shams, Pirbhat; Ali, Jamshed; Saadia, Sheema; Khan, Aamir Hameed; Sultan, Fateh Ali Tipoo; Tai, Javed
• Is Part Of: Annals of medicine and surgery. Volume 71(2021)
• Publication Date: 2021-11
• Subjects: Case report -- Arrythmia -- COVID19 -- Humoral -- Heart block -- Atrioventricular block -- CIED; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102956
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Importance: Bradyarrhythmia during COVID19 illness carries prognostic significance. Electrophysiological side effects of COVID19 vaccine remain largely unknown. It is imperative to report nature of cardiovascular side effects of the vaccine. Case presentation: An 80 years-old-man presented with complains of dizziness, trepidation and shortness of breath following his first shot of COVID-19 BBIBP-CorV (Sino-pharm). ECG on arrival showed 2:1 atrioventricular block with an underlying old left bundle branch block. The AV block changed into Mobitz type-I over the course of next 2 days and into a sinus 1:1 conduction on fourth day of presentation. However, our patient underwent permanent pacemaker implantation due to the underlying conduction tissue disease and intermittent 2:1 AV block during the hospital stay. Clinical discussion: It is likely that patients with an already diseased conduction system are at an increased risk of worsening of AV block following inoculation of the vaccine. Vaccine associated AV blocks are likely to be reversible. Presence of prior coronary artery disease and electrical abnormalities are important considerations. Conclusion: COVID-19 vaccine may have added side effects in subjects with known heart disease. Humoral response towards the vaccine might interfere with the conduction system of the heart and more so in patients with diseased and scarred myocardium. Highlights: Patients with underlying existing conduction tissue disease might be at an increased risk of worsening of AV block following inoculation of BBIBP-CorV vaccine. Decision to implant permanent pacemaker should be indivisualised based on presence of prior coronary artery disease, conduction tissue abnormality, overall life expectancy and symptom correlation.