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Prospective arrhythmia surveillance after a COVID-19 diagnosis
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
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
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Journal article
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2022-01-20
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Medicine
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https://doi.org/10.1136/openhrt-2021-001758
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.
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Dewland TA, Whitman IR, Win S, et alProspective arrhythmia surveillance after a COVID-19 diagnosisOpen Heart 2022;9:e001758. doi: 10.1136/openhrt-2021-001758
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BMJ Publications
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Open Heart, Vol. 9
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