RT Journal Article
SR Electronic
T1 Prospective arrhythmia surveillance after a COVID-19 diagnosis
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e001758
DO 10.1136/openhrt-2021-001758
VO 9
IS 1
A1 Dewland, Thomas A
A1 Whitman, Isaac R
A1 Win, Sithu
A1 Sanchez, Jose M
A1 Olgin, Jeffrey E
A1 Pletcher, Mark J
A1 Santhosh, Lekshmi
A1 Kumar, Uday
A1 Joyce, Sean
A1 Yang, Vivian
A1 Hwang, Janet
A1 Ogomori, Kelsey
A1 Peyser, Noah
A1 Horner, Cathy
A1 Wen, David
A1 Butcher, Xochitl
A1 Marcus, Gregory M
YR 2022
UL http://openheart.bmj.com/content/9/1/e001758.abstract
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.