Incidence of cardiac arrhythmias in patients with COVID-19 infection according to 24-hour electrocardiogram monitoring

Abstract

Cardiac arrhythmias in patients with COVID-19 infection may be due to many pathophysiological factors. Further study on the structure of arrhythmias in this category of patients will reveal clinically significant arrhythmias and select the optimal management. The aim: to determine the features of arrhythmias in patients with and without concomitant cardiovascular disease who suffered from COVID-19 infection based on the results of 24-hour electrocardiogram (ECG) monitoring. Materials and methods. 84 patients (45 men – 53.5 %, 39 women – 46.5 %) who had COVID-19 infection over 12 weeks previously were examined. Patients were divided into 2 groups – with and without a history of concomitant cardiovascular disease. The patient groups did not differ in age (P = 0.33) and sex (P = 0.58, P = 0.64). 24-hour ECG monitoring was performed on a Cardiosens K device (XAI-MEDICA, Kharkiv) according to the standard method. Results. Comparison of 12-channel ECG data did not reveal a significant difference in the incidence of single atrial (P = 0.13) and ventricular extrasystoles (P = 0.37) between the two groups, but sinus tachycardia was significantly more common in patients without concomitant cardiovascular disease (P = 0.022). According to 24-hour ECG monitoring, a significantly higher total number of arrhythmias, in particular, supraventricular extrasystoles (P = 0.009), high gradations of ventricular arrhythmias: paired ventricular extrasystoles (P = 0.041), ventricular bigeminy (P = 0.005), ventricular trigeminy (P = 0.004), ventricular salvos (P = 0.017) were detected significantly more frequently in patients with concomitant cardiovascular disease after COVID-19 infection than those in the comparison group. The results of 24-hour ECG monitoring also showed that patients without cardiovascular disease were significantly more likely to have inappropriate sinus tachycardia (P = 0.03) and postural orthostatic tachycardia (P = 0.04). Paroxysmal arrhythmias were significantly more common in patients with concomitant cardiovascular pathology, namely unstable (P = 0.002) and stable paroxysms of atrial tachycardia (P = 0.014), unstable paroxysms of monomorphic ventricular tachycardia (8.3 %), paroxysms of atrial fibrillation (6.2 %). Conclusions. 24-hour ECG monitoring should be advised in patients with COVID-19 infection and concomitant cardiovascular disease in addition to recording a standard 12-channel ECG to detect prognostically unfavorable cardiac arrhythmias, possible arrhythmogenic manifestations of post-COVID-19 syndrome and choose management tactics for these patients.

Development of an atrioventricular block prediction of method for portable heart monitoring system

“…In [7], a method for non-invasive electrophysiological study of the heart was proposed, based on the registration of multiple leads or the method of ECG mapping of the heart, which is one of the most informative methods for studying ECS. The use of twelve-channel recorders to detect rhythm disturbances is not appropriate: the study becomes less comfortable, but the presence of leads does not provide additional information about heart rhythm disturbances.…”

“…where α, β are positive constants. In (7), the H-S interval can be expressed in terms of the previous S-H interval. Then the recovery curve can be represented as follows:…”

Coronavirus Disease: Impact on Risk and Clinical Course of Cardiovascular Diseases

“…Наразі переконливо доведено, що наявність існуючого кардіоваскулярного захворювання є вагомим фактором ризику несприятливого перебігу захворювання, а також підвищує імовірність розвитку кардіоваскулярних ускладнень у постковідний період. Так, за даними холтеровського моніторування ЕКГ, у пацієнтів з кардіоваскулярними захворюваннями в анамнезі через 12 тижнів після гострої фази COVID-19 частота виявлення таких порушень серцевого ритму, як суправентрикулярна екстрасистолія, різноманітні форми шлуночкової екстрасистолії, пароксизмальні форми порушення ритму була вірогідно вищою ніж у пацієнтів з необтяженим анамнезом [10].…”