C12. Atrial Fibrillation post Sinovac-Coronavac Vaccine : A Case Report

Abstract

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.