COVID-19 Collection
Contemporary Trends in Cardiac Electrophysiology Procedures in the United States, and Impact of a Global Pandemic
There are limited data on trends in nationwide cardiac electrophysiology (EP) procedures in the United States before and during the global COVID-19 pandemic.Incidence and implications of atrial fibrillation in patients hospitalized for COVID compared to non-COVID pneumonia: A multicenter cohort study
Atrial fibrillation (AF) has been reported to occur with coronavirus disease 2019 (COVID-19), but whether it is related to myocarditis or lung injury is unclear.Increase in atrial fibrillation–related mortality in the United States during the COVID-19 pandemic
The coronavirus disease 2019 (COVID-19) pandemic has caused more deaths due to both COVID-19 and other clinical conditions such as cardiovascular disease. The relationship between atrial fibrillation (AF) and COVID-19 infection is complex.1 Indeed, AF has found to be associated with a significantly increased risk of short-term mortality in patients infected with severe acute respiratory syndrome coronavirus 2.2 Furthermore, patients with COVID-19 per se have an increased risk of developing AF.3 The aim of the present study was to investigate the trend of AF-related mortality in the United States before and during the COVID-19 pandemic.Successful treatment of acquired heart block with ablation
Transient episodes of atrioventricular (AV) block may be due to vagal stimuli such as in neurocardiogenic syncope, paroxysmal AV block due to His/Purkinje disease, inflammation, infection, or injury. In this case, a unique explanation for episodic heart block is suggested, with successful treatment.Genetic basis of sudden death after COVID-19 vaccination in Thailand
Severe acute respiratory syndrome coronavirus 2 vaccination reduces morbidity and mortality associated with coronavirus disease 2019 (COVID-19); unfortunately, it is associated with serious adverse events, including sudden unexplained death (SUD).COVID-19 vaccination in patients with long QT syndrome
Patients with long QT syndrome (LQTS) face potential threats from COVID-19 vaccination. Fever is one of the issues that is not uncommon after vaccination, and it usually takes place within 2 days. In particular, patients with type 2 LQTS based on trafficking-deficient variants are probably vulnerable to arrhythmogenicity under febrile conditions. Furthermore, myocarditis is one of the rare complications that is possibly associated with acquired QT prolongation and puts patients with LQTS at risk of life-threatening arrhythmia.Postural orthostatic tachycardia syndrome as a sequela of COVID-19
Postural orthostatic tachycardia syndrome (POTS) is a complex multisystem disorder characterized by orthostatic intolerance and tachycardia and may be triggered by viral infection. Recent reports indicate that 2%–14% of coronavirus disease 2019 (COVID-19) survivors develop POTS and 9%–61% experience POTS-like symptoms, such as tachycardia, orthostatic intolerance, fatigue, and cognitive impairment within 6–8 months of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Pathophysiological mechanisms of post–COVID-19 POTS are not well understood.Impact of COVID-19 pandemic on cardiac rhythm management services: Views from the United Kingdom
Effects of the COVID-19 pandemic on cardiac rhythm management (CRM) services remain poorly quantified.Author’s Reply—COVID-19 vaccination and torsades de pointes
We appreciate the comments Drs Mungmunpuntipantip and Wiwanitkit have regarding our case report “Torsades de Pointes Following Vaccination for COVID-19.”1 While we agree that it is impossible to draw definitive conclusions regarding causality of the ventricular arrhythmia seen in our patient, our report raises concerns about the COVID-19 vaccinations she received. She was otherwise healthy and asymptomatic until she developed syncope 1 month after the second vaccination and suffered a cardiac arrest within 12 hours after receiving the booster.To the Editor—COVID-19 vaccination and torsades de pointes
We read the publication on “Torsades de Pointes Following Vaccination for COVID-19.”1 Abrich and Olshansky reported the case and discussed the interrelationship. We agree that the COVID-19 vaccine has the potential to induce side effects, such as irregular heart rhythm. The current case may or may not indicate an adverse reaction to the COVID-19 vaccination. It’s impossible to draw any conclusions because there’s no information on prevaccination health or cardiac rhythm. There’s a potential that a background personal disease or a concurrent medical problem will cause cardiac rhythm problems.Torsades de pointes following vaccination for COVID-19
Torsades de pointes is a polymorphic ventricular tachycardia that can cause syncope and lead to sudden cardiac death. This arrhythmia is initiated by early afterdepolarizations in the setting of prolonged ventricular repolarization, manifesting as QT prolongation on the 12-lead electrocardiogram (ECG).1 Common risk factors include QT-prolonging medications, electrolyte disturbances, bradycardia, and certain inherited genetic mutations.2 We report a case of torsades de pointes that occurred shortly after vaccination for COVID-19.Unmasked type 1 Brugada ECG pattern without a fever after a COVID-19 vaccination
Brugada syndrome (BrS) patients are regarded as a high-risk population under the COVID-19 pandemic because infection-induced fevers may unmask a type 1 Brugada electrocardiogram (ECG) pattern potentially leading to lethal ventricular arrhythmias.1 Vaccinations seem to be crucial in BrS patients; however, careful observation and antipyretic drugs are necessary for vaccine-induced fevers.2 Among the enormous number of COVID-19 vaccinations around the world, although the incidence is rare, death events, including sudden cardiac death, after a vaccination have been reported.Arrhythmias in the COVID-19 patient
Coronavirus disease 2019 (COVID-19) has encompassed the globe since it was first observed just under 2 years ago. Although the disease is predominantly a respiratory illness, there have been observed complications throughout the various organ systems. Namely, cardiovascular complications, and, more specifically, arrhythmic complications have been described throughout the pandemic in patients with COVID-19. Management of atrial arrhythmias, ventricular arrhythmias, and bradyarrhythmias in patients with COVID-19 infection has been largely guided by our prior experience in the management of these arrhythmias in similar patient populations without infection.Identifying risk of adverse outcomes in COVID-19 patients via artificial intelligence–powered analysis of 12-lead intake electrocardiogram
Adverse events in COVID-19 are difficult to predict. Risk stratification is encumbered by the need to protect healthcare workers. We hypothesize that artificial intelligence (AI) can help identify subtle signs of myocardial involvement in the 12-lead electrocardiogram (ECG), which could help predict complications.Theophylline to treat prolonged paroxysmal complete atrioventricular block without conduction disorder or structural heart disease after COVID-19 infection: A case report
The novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a positive-sense, single-stranded RNA virus. The most common symptoms include cough, fever, fatigue, shortness of breath, sore throat, and headache. Although respiratory failure is the primary complication seen in COVID-19 patients, the cardiovascular system can also be targeted with complications, including myocardial injury, myocarditis, arrhythmias, heart failure, and acute myocardial infarction.Patient-specific, re-engineered cardiomyocyte model confirms the circumstance-dependent arrhythmia risk associated with the African-specific common SCN5A polymorphism p.S1103Y: Implications for the increased sudden deaths observed in black individuals during the COVID-19 pandemic
During the early stages of the coronavirus disease 2019 (COVID-19) pandemic, a marked increase in sudden cardiac death (SCD) was observed. The p.S1103Y-SCN5A common variant, which is present in ∼8% of individuals of African descent, may be a circumstance-dependent, SCD-predisposing, proarrhythmic polymorphism in the setting of hypoxia-induced acidosis or QT-prolonging drug use.Autonomic dysfunction and post–COVID-19 syndrome: A still elusive link
Infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing the long-lasting pandemic coronavirus disease 2019 (COVID-19), with dramatic clinical, social, and economic implications. Importantly, evolving experience consistently shows that, in addition to issues related to the acute phase, patients who recover from COVID-19 may present a wide variety of bothersome symptoms, which may be debilitating and significantly impair their quality of life. This condition, when it persists beyond 12 weeks after recovery, is defined as “post–COVID-19” or “long COVID-19” syndrome.Dysautonomia following COVID-19 is not associated with subjective limitations or symptoms but is associated with objective functional limitations
Individuals who contract coronavirus disease 2019 (COVID-19) can suffer with persistent and debilitating symptoms long after the initial acute illness. Heart rate (HR) profiles determined during cardiopulmonary exercise testing (CPET) and delivered as part of a post-COVID recovery service may provide insight into the presence and impact of dysautonomia on functional ability.Autonomic dysfunction post–acute COVID-19 infection
SARS-CoV-2 infection, which causes the disease COVID-19, is most known for its severe respiratory complications. However, a variety of extrapulmonary effects have since been described, with cardiovascular complications being among the most common.1 Those who recover from the acute phase of COVID-19 may be left with residual symptoms such as chest pain and dyspnea, resulting in a decreased quality of life and a syndrome sometimes described as “long COVID.”2 Recent evidence suggests that survivors with some of these chronic symptoms may have autonomic dysfunction (AD) with features of postural orthostatic tachycardia syndrome (POTS) and/or inappropriate sinus tachycardia (IST).A cardiovascular clinic patients’ survey to assess challenges and opportunities of digital health adoption during the COVID-19 pandemic
COVID-19 boosted healthcare digitalization and personalization in cardiology. However, understanding patient attitudes and engagement behaviors is essential to achieve successful acceptance and implementation of digital health technologies in personalized care.Pacing through a pandemic—Coping with the “tip of the iceberg”
The coronavirus disease 2019 (COVID-19) pandemic has presented a once in a generation challenge to our health care systems worldwide. In its early phases, confusion existed about modes of transmission, levels of infection control, and risk to health care personnel. This combined with lack of resources for adequate personal protective equipment (PPE) generated high levels of anxiety for medical teams and rationing of PPE in the early phase. Advise and local guidelines were changing on an almost daily basis, with major challenges in procedural risk assessment in the absence of immediate polymerase chain reaction testing: COVID-19 positivity was assumed until proven otherwise.Evaluating factors of greater patient satisfaction with outpatient cardiology telehealth visits during the COVID-19 pandemic
The impact of telehealth on cardiovascular care during the COVID-19 pandemic on patient satisfaction and factors associated with satisfaction are not well characterized.Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey
Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown.Effects of COVID-19 pandemic on physical activity in children and young adults with implanted devices
Children and young adults with preexisting cardiovascular disease (CVD) may be disproportionately affected by the collateral health consequences of the coronavirus disease 2019 (COVID-19) pandemic. In addition to a higher risk of morbidity and mortality from COVID-19,1 young persons with CVD may be more susceptible to alterations in physical activity (PA) and poor health outcomes2 owing to the unprecedented loss of structured school days, reduced sports participation, increased screen time, and social isolation.Patient Perspective: We have embraced digital technologies to support arrhythmia patients during the COVID-19 pandemic
National Health Service (NHS) England views shared decision-making as a vital part of providing good care, describing it as “a process in which clinicians and individuals work together to select tests, treatments, management, or support packages, based on evidence and the individual’s informed preferences.”1 It also states the need for “evidence-based decision support tools that are tailored to support people (especially those with low levels of health literacy) to understand their options and what is known of the benefits, harms, consequences, and burdens of those options.”
