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2020 ; 17
(9
): 1439-1444
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COVID-19 and cardiac arrhythmias
#MMPMID32585191
Bhatla A
; Mayer MM
; Adusumalli S
; Hyman MC
; Oh E
; Tierney A
; Moss J
; Chahal AA
; Anesi G
; Denduluri S
; Domenico CM
; Arkles J
; Abella BS
; Bullinga JR
; Callans DJ
; Dixit S
; Epstein AE
; Frankel DS
; Garcia FC
; Kumareswaram R
; Nazarian S
; Riley MP
; Santangeli P
; Schaller RD
; Supple GE
; Lin D
; Marchlinski F
; Deo R
Heart Rhythm
2020[Sep]; 17
(9
): 1439-1444
PMID32585191
show ga
BACKGROUND: Early studies suggest that coronavirus disease 2019 (COVID-19) is
associated with a high incidence of cardiac arrhythmias. Severe acute respiratory
syndrome coronavirus 2 infection may cause injury to cardiac myocytes and
increase arrhythmia risk. OBJECTIVES: The purpose of this study was to evaluate
the risk of cardiac arrest and arrhythmias including incident atrial fibrillation
(AF), bradyarrhythmias, and nonsustained ventricular tachycardia (NSVT) in a
large urban population hospitalized for COVID-19. We also evaluated correlations
between the presence of these arrhythmias and mortality. METHODS: We reviewed the
characteristics of all patients with COVID-19 admitted to our center over a
9-week period. Throughout hospitalization, we evaluated the incidence of cardiac
arrests, arrhythmias, and inpatient mortality. We also used logistic regression
to evaluate age, sex, race, body mass index, prevalent cardiovascular disease,
diabetes, hypertension, chronic kidney disease, and intensive care unit (ICU)
status as potential risk factors for each arrhythmia. RESULTS: Among 700 patients
(mean age 50 ± 18 years; 45% men; 71% African American; 11% received ICU care),
there were 9 cardiac arrests, 25 incident AF events, 9 clinically significant
bradyarrhythmias, and 10 NSVTs. All cardiac arrests occurred in patients admitted
to the ICU. In addition, admission to the ICU was associated with incident AF
(odds ratio [OR] 4.68; 95% confidence interval [CI] 1.66-13.18) and NSVT (OR
8.92; 95% CI 1.73-46.06) after multivariable adjustment. Also, age and incident
AF (OR 1.05; 95% CI 1.02-1.09) and prevalent heart failure and bradyarrhythmias
(OR 9.75; 95% CI 1.95-48.65) were independently associated. Only cardiac arrests
were associated with acute in-hospital mortality. CONCLUSION: Cardiac arrests and
arrhythmias are likely the consequence of systemic illness and not solely the
direct effects of COVID-19 infection.
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