COVID-19 Vaccination and Cardiac Arrhythmias: A Review.
Bavithra PariAkhilesh BabbiliAyeesha KattubadiAnuj ThakreSahithreddy ThotamgariRakesh GopinathannairBrian OlshanskyPaari DominicPublished in: Current cardiology reports (2023)
A global survey has exposed an incidence of arrhythmia in 18.27% of hospitalized COVID-19 patients. Furthermore, any type of COVID-19 vaccine - be it mRNA, adenovirus vector, whole inactivated, or protein subunit - appears to instigate cardiac arrhythmias. Among the cardiac adverse events reported post-COVID-19 vaccination, myocarditis emerges as the most common and is thought to be a potential cause of bradyarrhythmia. When a patient post-COVID-19 vaccination presents a suspicion of cardiac involvement, clinicians should perform a comprehensive history and physical examination, measure electrolyte levels, conduct ECG, and carry out necessary imaging studies. In our extensive literature search, we uncovered various potential mechanisms that might lead to cardiac conduction abnormalities and autonomic dysfunction in patients who have received the COVID-19 vaccine. These mechanisms encompass direct viral invasion through molecular mimicry/spike (S) protein production, an escalated inflammatory response, hypoxia, myocardial cell death, and the eventual scar/fibrosis. They correspond to a range of conditions including atrial tachyarrhythmias, bradyarrhythmia, ventricular arrhythmias, sudden cardiac death, and the frequently occurring myocarditis. For treating these COVID-19 vaccination-induced arrhythmias, we should incorporate general treatment strategies, similar to those applied to arrhythmias from other causes.
Keyphrases
- sars cov
- coronavirus disease
- left ventricular
- inflammatory response
- cell death
- congenital heart disease
- respiratory syndrome coronavirus
- end stage renal disease
- heart failure
- chronic kidney disease
- heart rate variability
- systematic review
- heart rate
- physical activity
- ejection fraction
- mental health
- blood pressure
- newly diagnosed
- prognostic factors
- small molecule
- high resolution
- left atrial
- catheter ablation
- signaling pathway
- risk factors
- toll like receptor
- endothelial cells
- diabetic rats
- human health
- patient reported
- cell cycle arrest
- case report
- cell migration
- liver fibrosis