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 Thomas A Dewland A1 Isaac R Whitman A1 Sithu Win A1 Jose M Sanchez A1 Jeffrey E Olgin A1 Mark J Pletcher A1 Lekshmi Santhosh A1 Uday Kumar A1 Sean Joyce A1 Vivian Yang A1 Janet Hwang A1 Kelsey Ogomori A1 Noah Peyser A1 Cathy Horner A1 David Wen A1 Xochitl Butcher A1 Gregory M Marcus 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.