Cardiac arrhythmias in patients with COVID‐19

Abstract

The emergence of coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has become a major global public health concern. Although SARS‐CoV‐2 causes primarily respiratory problems, concurrent cardiac injury cannot be ignored since it may be an independent predictor for adverse outcomes. Cardiac arrhythmias are often observed in patients with COVID‐19, especially in severe cases, and more likely contribute to the high risk of adverse outcomes. Arrhythmias should be regarded as one of the main complications of COVID‐19. Mechanistically, a number of ion channels can be adversely affected in COVID‐19, leading to alterations in cardiac conduction and/or repolarization properties, as well as calcium handling, which can predispose to cardiac arrhythmogenesis. In addition, several antimicrobials that are currently used as potential therapeutic agents for COVID‐19, such as chloroquine, hydroxychloroquine and azithromycin, have uncertain benefit, and yet may induce electrocardiographic QT prolongation with potential ventricular pro‐arrhythmic effects. Continuous electrocardiogram monitoring, accurate and prompt recognition of arrhythmias are important. The present review focuses on cardiac arrhythmias in patients with COVID‐19, its underlying mechanisms, and proposed preventive and therapeutic strategies.

Abstract

Diagnosis and management of coronavirus disease 2019 (COVID‐19) related arrhythmias. Arrhythmias are the main complications of COVID‐19. Tachycardia, atrioventricular/intraventricular conduction block, ST‐T changes, QT interval prolongation, and even malignant arrhythmias are observed in COVID‐19 patients. Continuous electrocardiogram monitoring, accurate and prompt recognition, and ppropriate treatments of arrhythmias are important. COVID‐19, Coronavirus disease 2019; ECG, Electrocardiogram; MCOT, Mobile continuous telemetry monitor.