PT  - JOURNAL ARTICLE
AU  - Dewland, Thomas A
AU  - Whitman, Isaac R
AU  - Win, Sithu
AU  - Sanchez, Jose M
AU  - Olgin, Jeffrey E
AU  - Pletcher, Mark J
AU  - Santhosh, Lekshmi
AU  - Kumar, Uday
AU  - Joyce, Sean
AU  - Yang, Vivian
AU  - Hwang, Janet
AU  - Ogomori, Kelsey
AU  - Peyser, Noah
AU  - Horner, Cathy
AU  - Wen, David
AU  - Butcher, Xochitl
AU  - Marcus, Gregory M
TI  - Prospective arrhythmia surveillance after a COVID-19 diagnosis
AID  - 10.1136/openhrt-2021-001758
DP  - 2022 Jan 01
TA  - Open Heart
PG  - e001758
VI  - 9
IP  - 1
4099  - http://openheart.bmj.com/content/9/1/e001758.short
4100  - http://openheart.bmj.com/content/9/1/e001758.full
SO  - Open Heart2022 Jan 01; 9
AB  - 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.