Arrhythmias and COVID-19: A Review
Parinita Dherange1, Joshua Lang1, Pierre Qian1
1Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
JACC. Clinical Electrophysiology
|September 25, 2020
Summary
Cardiac arrhythmias are more common in critically ill patients with coronavirus disease-2019 (COVID-19). Management requires awareness of drug interactions, QTc prolongation monitoring, and special considerations for inherited arrhythmia syndromes.
Area of Science:
- Cardiology
- Infectious Diseases
- Genetics
Background:
- The impact of coronavirus disease-2019 (COVID-19) on cardiac arrhythmias is an evolving area of research.
- Cardiac arrhythmias are frequently observed in critically ill COVID-19 patients.
Purpose of the Study:
- To summarize the current understanding of COVID-19's impact on cardiac arrhythmias.
- To outline potential mechanisms of arrhythmogenesis in COVID-19 patients.
- To highlight key management strategies for arrhythmias in the context of COVID-19.
Main Methods:
- Literature review of current data on COVID-19 and cardiac arrhythmias.
- Analysis of potential pathophysiological mechanisms.
- Discussion of clinical management strategies and future research needs.
Main Results:
- COVID-19 is associated with an increased incidence of cardiac arrhythmias, particularly in severe cases.
- Potential arrhythmogenic mechanisms include hypoxia, myocarditis, immune response, ischemia, strain, electrolyte imbalances, and drug effects.
- Effective management involves monitoring for QTc prolongation, awareness of drug interactions, and tailored care for patients with inherited arrhythmia syndromes.
Conclusions:
- Further research is necessary to fully elucidate the pathophysiology of COVID-19-related arrhythmias.
- Validated management strategies are crucial given the ongoing prevalence of COVID-19 and potential for future surges.
- Minimizing infection exposure through telemedicine and risk stratification is essential.
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