Background COVID-19 has become a global pandemic. Vaccines are currently used to reduce the morbidity and mortality of the disease. However, research regarding the use of the vaccine is still ongoing. Atrial fibrillation (AF) is one of the rare findings after receiving the COVID-19 vaccine. Case Summary A man, 64 years old, presented to the ER with palpitation an hour before admission. He refused to have any angina symptoms. Previously, he got a Sinovac-Coronavac injection one day before. On examination, BP 100/60, HR 114, RR 24, SpO2 99% room air, sub-febrile, other findings within normal limits. ECG showed AF with rapid ventricular response. A routine blood test showed no abnormality, rapid antigen SARS-COV2 negative, and hs Troponin I (hsTn-I) 2.5 ng/L. The patient was diagnosed with atrial fibrillation and given oxygen, amiodarone, aspirin, atorvastatin, and serial ECG post-therapy. ECG post therapy converted into sinus rhythm after 26 hours. Discussion Acute SARS-CoV-2 infection increases the susceptibility to new-onset atrial fibrillation (NOAF), but the pathophysiology is not well understood. After receiving the COVID-19 vaccine, the immune system will mimic primary infection. It was unclear why our patients developed NOAF. However, we found an observational zone hs-TnI value and a sub-febrile temperature. Troponin might be elevated in critically ill patients even without myocardial involvement, but this patient is in a good state. However, the correlation between atrial fibrillation and the COVID-19 vaccine is not well understood because of the lack of data.

Background COVID-19 has become a global pandemic. Vaccines are currently used to reduce the morbidity and mortality of the disease. However, research regarding the use of the vaccine is still ongoing. Atrial fibrillation (AF) is one of the rare findings after receiving the COVID-19 vaccine. Case Summary A man, 64 years old, presented to the ER with palpitation an hour before admission. He refused to have any angina symptoms. Previously, he got a Sinovac-Coronavac injection one day before. On examination, BP 100/60, HR 114, RR 24, SpO2 99% room air, sub-febrile, other findings within normal limits. ECG showed AF with rapid ventricular response. A routine blood test showed no abnormality, rapid antigen SARS-COV2 negative, and hs Troponin I (hsTn-I) 2.5 ng/L. The patient was diagnosed with atrial fibrillation and given oxygen, amiodarone, aspirin, atorvastatin, and serial ECG post-therapy. ECG post therapy converted into sinus rhythm after 26 hours. Discussion Acute SARS-CoV-2 infection increases the susceptibility to new-onset atrial fibrillation (NOAF), but the pathophysiology is not well understood. After receiving the COVID-19 vaccine, the immune system will mimic primary infection. It was unclear why our patients developed NOAF. However, we found an observational zone hs-TnI value and a sub-febrile temperature. Troponin might be elevated in critically ill patients even without myocardial involvement, but this patient is in a good state. However, the correlation between atrial fibrillation and the COVID-19 vaccine is not well understood because of the lack of data.

Background and Aims Arrhythmia, especially atrial fibrillation (AF), is a common complication post coronary artery bypass graft (CABG) surgery and a major source of morbidity and mortality. This meta-analysis aims to evaluate the use of magnesium sulfate (MgSO4) as AF prophylaxis post CABG surgery. Method and Results A total of 10 studies enrolled 1,371 patients (1,114 males and 257 females) were retrieved from Pubmed, Cochrane, and Medline until July 2021 to identify studies about the association between MgSO4 and AF occurrence post CABG surgery. All suitable full text must accomplish Jadad score ≥2 for assessing study quality. Data were analyzed using Review Manager 5.3. Mantel-Haenszel formula was used for dichotomous variables to calculate the odds ratio (OR). Our results showed MgSO4 group (n = 711) compared to the placebo group (n = 660) were at decreased odds of having AF post CABG surgery (OR 0.59; 95%CI 0.39 to 0.91; p = 0.03) with AF occurrence in 134 patients and 188 patients, respectively. Data were derived from the random-effects model due to the heterogenous result between studies (Tau2=0.22, Chi2=18.99, df = 9 [p = 0.03], I2 = 53%). Conclusion This meta-analysis showed that administration of MgSO4 decreased the occurrence of AF occurrence post CABG surgery. Further research is needed to determine the optimal MgSO4 dose and time of administration.