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Published on: February 28, 2012
Association between COVID-19 vaccination and atrial arrhythmias in individuals with cardiac implantable electronic
Abhishek J Deshmukh1, Rimsha Ahmad1, Yong-Mei Cha1
1Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Insights
COVID-19 vaccination showed a small increase in atrial arrhythmias (AA) post-dose, similar to influenza vaccine effects. This rise in AA is likely due to natural disease progression, not the vaccine itself.
Area of Science:
- Cardiology
- Vaccinology
- Public Health
Background:
- The effects of mRNA-based coronavirus disease-2019 (COVID-19) vaccines on atrial arrhythmias (AA) and ventricular arrhythmias are not well understood.
- Understanding potential cardiac implications of COVID-19 vaccination is crucial for public health strategies.
Purpose of the Study:
- To investigate the incidence of atrial arrhythmias (AA) and ventricular arrhythmias following COVID-19 vaccination in patients with cardiac implantable electronic devices (CIEDs).
- To compare the burden of AA before and after COVID-19 vaccination and evaluate the impact of influenza vaccination.
Main Methods:
- Utilized BIOTRONIK Home Monitoring and Medicare Claims data for individuals with CIEDs who received COVID-19 vaccine.
- Compared the burden of AA in the 3 months postvaccination to the preceding 3 months.
- Performed propensity score matching to compare vaccinated and unvaccinated patients.
Main Results:
- A small, statistically significant increase in AA burden was observed post-first dose of COVID-19 vaccine.
- Similar increases in AA were noted following influenza vaccination and in unvaccinated matched patients.
- No significant differences in device therapies were observed pre- and post-vaccination.
Conclusions:
- The observed increase in CIED-detected AAs post-COVID-19 vaccination is likely associated with the natural progression of atrial fibrillation (AF) rather than the vaccine.
- These findings do not warrant discouraging COVID-19 vaccination.
- Increased vigilance and prompt AF treatment are recommended for high-risk individuals, particularly males over 70, post-vaccination.
Introduction:
The impact of mRNA-based coronavirus disease-2019 (COVID-19) vaccines on atrial arrhythmias (AA) and ventricular arrhythmias incidence is unknown.
Methods:
BIOTRONIK Home Monitoring data and Medicare Claims data were utilized to identify individuals implanted with a cardiac implantable electronic device (CIED) between 2010 and 2020 who received one or more doses of COVID-19 vaccine in 2021. The burden of AA (%) in the 3 months postvaccination was compared to those noted in the preceding 3 months using the Wilcoxon signed rank test. Sub-analyses comparing the effects of the influenza vaccine against the COVID-19 vaccine were also evaluated for individuals who received the influenza vaccine in 2020. A 1:1 propensity score match comparison between COVID-19 vaccine and non-vaccinated patients was also performed.
Results:
First and second doses of the COVID-19 vaccine were administered to 7757 and 6579 individuals with a CIED (age 76.2 ± 9.0 years, 49% males), respectively. While a small but statistically significant increase in the burden of AA was noted in the 3 months postvaccination compared to the preceding 3 months after the first dose of the COVID-19 vaccine (0.43 ± 9.04%, p = .028) a similar rise in AA was found following the influenza vaccine and for matched patients who did not receive the COVID-19 vaccine. No significant difference in device therapies was seen pre- and postvaccination.
Conclusions:
Though we report a small but significant increase in the number of CIED-detected AAs following vaccination for COVID-19 over a 3-month window, we believe these results correlate more with time and the progressive nature of AF rather than the vaccine itself. While these data should not dissuade from the use of these vaccines, increased vigilance and prompt treatment of AF is required for high-risk groups, specifically males over 70 years of age, following vaccination.
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