%0 Journal Article %A Thomas A Dewland %A Isaac R Whitman %A Sithu Win %A Jose M Sanchez %A Jeffrey E Olgin %A Mark J Pletcher %A Lekshmi Santhosh %A Uday Kumar %A Sean Joyce %A Vivian Yang %A Janet Hwang %A Kelsey Ogomori %A Noah Peyser %A Cathy Horner %A David Wen %A Xochitl Butcher %A Gregory M Marcus %T Prospective arrhythmia surveillance after a COVID-19 diagnosis %D 2022 %R 10.1136/openhrt-2021-001758 %J Open Heart %P e001758 %V 9 %N 1 %X 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.Data are available upon reasonable request. %U https://openheart.bmj.com/content/openhrt/9/1/e001758.full.pdf