COVID-19 and Cardiac Arrhythmias: Lesson Learned and Dilemmas
🔥Again, an interesting review article with the bottom line: #YouOnlyHaveOneHeart, protect it!
➡️Among the different cardiovascular complications of the SARS-CoV-2 infection, CARDIAC ARRHYTHMIAS represent an important clinical manifestation requiring proper therapy both in the acute and post-acute phase.
➡️During SARS-CoV-2 infection, the occurrence of cardiac arrhythmias recognizes variable pathophysiologic mechanisms, which may interact and increase the chance of arrhythmic manifestations.
➡️This may be associated with a worse prognosis, especially in critically ill patients with new-onset cardiac arrhythmias, but every SARS-CoV-2 infection carries the risk!( Risk probably only increases with reinfections).
➡️Moreover, peculiarly, the pathophysiologic mechanism may act differently in different patients to originate different arrhythmias.
➡️In fact, paradoxically, the SARS-CoV-2 infection can be responsible for two opposite arrhythmic patterns,
1. Sick sinus syndrome(SSS) with Bradyarrhythmia’s( 46% III-degree AVBlock, 25% Sinus Bradycardia, 20% Sinus arrest, 9% II-degree AVBlock)
2. Inappropriate sinus tachycardia (IST), Atrial Fibrillation, supraventricular and ventricular Tachyarrhythmia’s,
➡️Which can probable be explained by direct viral damage in the first group(1) and by persistent dysregulation of the autonomic nervous system in the latter group(2), but several interacting infection related mechanisms( AT-2, Hypoxia, Inflammatory response, Myocardial Ischemia, Myocardial inflammation, Electrolyte imbalances a.o), need our attention too!
➡️Therefore, a deeper understanding of SARS-CoV-2 pathophysiology can lead to better recognition, treatment, and PREVENTION of COVID-19-related arrhythmias.
➡️Although treatment in these patients may not substantially differ from other patients( = non-sarscov2), there are still some grey zones that may pose dilemmas to clinicians in their decision making.
➡️Some dilemmas in the management of these patients are the need to implant in the acute or post-acute phase a permanent pacemaker or cardioverter/defibrillation in patients presenting with brady- or tachyarrhythmias and lifelong oral anticoagulation in new-onset atrial fibrillation detected during SARS-CoV-2 infection.
Important again: Cardiac Arrhythmias are NOT isolated to the acute SarsCoV2 infection period, they can also play a major role in LC and cause delayed sudden deaths, often not recognised as post-Covid-19!!
mdpi.com/2077-0383/13/2…
🔥Again, an interesting review article with the bottom line: #YouOnlyHaveOneHeart, protect it!
➡️Among the different cardiovascular complications of the SARS-CoV-2 infection, CARDIAC ARRHYTHMIAS represent an important clinical manifestation requiring proper therapy both in the acute and post-acute phase.
➡️During SARS-CoV-2 infection, the occurrence of cardiac arrhythmias recognizes variable pathophysiologic mechanisms, which may interact and increase the chance of arrhythmic manifestations.
➡️This may be associated with a worse prognosis, especially in critically ill patients with new-onset cardiac arrhythmias, but every SARS-CoV-2 infection carries the risk!( Risk probably only increases with reinfections).
➡️Moreover, peculiarly, the pathophysiologic mechanism may act differently in different patients to originate different arrhythmias.
➡️In fact, paradoxically, the SARS-CoV-2 infection can be responsible for two opposite arrhythmic patterns,
1. Sick sinus syndrome(SSS) with Bradyarrhythmia’s( 46% III-degree AVBlock, 25% Sinus Bradycardia, 20% Sinus arrest, 9% II-degree AVBlock)
2. Inappropriate sinus tachycardia (IST), Atrial Fibrillation, supraventricular and ventricular Tachyarrhythmia’s,
➡️Which can probable be explained by direct viral damage in the first group(1) and by persistent dysregulation of the autonomic nervous system in the latter group(2), but several interacting infection related mechanisms( AT-2, Hypoxia, Inflammatory response, Myocardial Ischemia, Myocardial inflammation, Electrolyte imbalances a.o), need our attention too!
➡️Therefore, a deeper understanding of SARS-CoV-2 pathophysiology can lead to better recognition, treatment, and PREVENTION of COVID-19-related arrhythmias.
➡️Although treatment in these patients may not substantially differ from other patients( = non-sarscov2), there are still some grey zones that may pose dilemmas to clinicians in their decision making.
➡️Some dilemmas in the management of these patients are the need to implant in the acute or post-acute phase a permanent pacemaker or cardioverter/defibrillation in patients presenting with brady- or tachyarrhythmias and lifelong oral anticoagulation in new-onset atrial fibrillation detected during SARS-CoV-2 infection.
Important again: Cardiac Arrhythmias are NOT isolated to the acute SarsCoV2 infection period, they can also play a major role in LC and cause delayed sudden deaths, often not recognised as post-Covid-19!!
mdpi.com/2077-0383/13/2…
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