Prospective arrhythmia surveillance after a COVID-19 diagnosis. Issue 1 (20th January 2022)

• Record Type: Journal Article
• Authors: Dewland, Thomas A; Whitman, Isaac R; Win, Sithu; Sanchez, Jose M; Olgin, Jeffrey E; Pletcher, Mark J; Santhosh, Lekshmi; Kumar, Uday; Joyce, Sean; Yang, Vivian; Hwang, Janet; Ogomori, Kelsey; Peyser, Noah; Horner, Cathy; Wen, David; Butcher, Xochitl; Marcus, Gregory M
• Is Part Of: Open heart. Volume 9:Issue 1(2022)
• Publication Date: 2022-01-20
• Subjects: COVID-19 -- arrhythmias -- electrophysiology; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Patients -- Periodicals; 616.12005
• DOI: 10.1136/openhrt-2021-001758
• Languages: English
• ISSNs: 2398-595X

Abstract

Abstract : Background: Cardiac arrhythmias have been observed among patients hospitalised with acute COVID-19 infection, and palpitations remain a common symptom among the much larger outpatient population of COVID-19 survivors in the convalescent stage of the disease. Objective: To determine arrhythmia prevalence among outpatients after a COVID-19 diagnosis. Methods: Adults with a positive COVID-19 test and without a history of arrhythmia were prospectively evaluated with 14-day ambulatory electrocardiographic monitoring. Participants were instructed to trigger the monitor for palpitations. Results: A total of 51 individuals (mean age 42±11 years, 65% women) underwent monitoring at a median 75 (IQR 34–126) days after a positive COVID-19 test. Median monitoring duration was 13.2 (IQR 10.5–13.8) days. No participant demonstrated atrial fibrillation, atrial flutter, sustained supraventricular tachycardia (SVT), sustained ventricular tachycardia or infranodal atrioventricular block. Nearly all participants (96%) had an ectopic burden of <1%; one participant had a 2.8% supraventricular ectopic burden and one had a 15.4% ventricular ectopic burden. While 47 (92%) participants triggered their monitor for palpitation symptoms, 78% of these triggers were for either sinus rhythm or sinus tachycardia. Conclusions: We did not find evidence of malignant or sustained arrhythmias in outpatients after a positive COVID-19 diagnosis. While palpitations were common, symptoms frequently corresponded to sinus rhythm/sinus tachycardia or non-malignant arrhythmias such as isolated ectopy or non-sustained SVT. While these findings cannot exclude the possibility of serious arrhythmias in select individuals, they do not support a strong or widespread proarrhythmic effect of COVID-19 infection after resolution of acute illness.