From Muscles to Wires: Report of Two Cases and Literature Review on COVID-19 Vaccination and Cardiac Conduction Disturbance

Abstract

Since the end of 2020, several vaccines have become available as part of the global efforts to contain the adverse health outcomes of the coronavirus disease 2019 (COVID-19) pandemic. Although research has confirmed their safety on large scales, several post-marketing reports have revealed some rare cardiovascular side effects. Towards the end of the first half of 2021, multiple reports indicate possible links between COVID-19 vaccines (both mRNA-based vaccine and vector-based vaccines) and myopericarditis. Nevertheless, cardiac conduction disease in this context has only rarely been reported.In this report, we present two cases of probable vaccination-induced cardiac conduction disturbances along with a thorough literature review. In addition, we discuss probable pathophysiological mechanisms and insights into the suggested areas for future research. To our knowledge, these are the first published cases to result in permanent pacemaker implantation.

Diagnostik von messenger Ribonukleinsäure (mRNA) severe acute respiratory syndrome-corona virus‑2 (SARS-CoV‑2) impfassoziierten Myokarditiden – ein systematischer Review

“…Reports of individuals with immanent myocarditis and conduction disturbances after the vaccination are available [ 59 ]. Whether this is a distinct entity, or a subform of subclinical myocarditis is not yet known, therefore postmortem work-up of fatalities in a chronological connection with a mRNA-SARS-CoV-2-immunization is necessary.…”

Intermittent complete heart block with ventricular standstill after Pfizer COVID‐19 booster vaccination: A case report

“…Documented cardiac complications include myocarditis, pericarditis, and cardiac arrhythmias. Although both myocarditis and pericarditis have been reported with some frequency in the literature, cardiac conduction abnormalities have been less prevalent 5–7 . Ours is the first reported case of intermittent complete heart block with ventricular standstill secondary to lymphocytic myocarditis suspected to be due to the Pfizer‐BioNTech COVID‐19 vaccine.…”

“…Although both myocarditis and pericarditis have been reported with some frequency in the literature, cardiac conduction abnormalities have been less prevalent. [5][6][7] Ours is the first reported case of intermittent complete heart block with ventricular standstill secondary to lymphocytic…”

COVID-19 mRNA Vaccination Mimicking Heart Attack in a Healthy 56-Year-Old Physician

“…These, however, are considered rare and emphasis is given on the efficacy and safety of the new technology mRNA vaccines and the benefits against the COVID-19 pandemic, which outweigh these potential rare side effects [ 4 ]. Such rare cardiovascular events that have been reported include myocarditis [ 4 , 5 ], pericarditis, paroxysmal ventricular arrythmia, tachycardia, bradycardia [ 5 , 6 ], myocardial infarction, hypertension, and Takotsubo cardiomyopathy [ 5 ]. These adverse events seem to be associated in a timely manner with the vaccine use, but their etiologic relationship cannot be proven yet [ 5 ].…”