Risks of Cardiac Arrhythmia Associated with COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aimed to summarize the current evidence regarding the association between coronavirus disease 2019 (COVID-19) vaccination and the risk of cardiac arrhythmia. MEDLINE, via PubMed and OVID, Scopus, CENTRAL, and Web of Science were searched using the relevant keywords to identify the relevant citations. Comprehensive Meta-analysis and Review Manager 5.4.1 were used for all the statistical analyses. Seventeen studies (n = 567,033,087 patients) were included. The pooled analysis showed that the incidence of cardiac arrhythmia post-COVID-19 vaccination with Pfizer, Moderna, AstraZeneca, CoronaVac, and Sinopharm was 0.22%, 95% CI: (0.07% to 0.66%), 0.76%, 95% CI: (0.04% to 12.08%), 0.04%, 95% CI: (0.00% to 0.98%), 0.01%, 95% CI: (0.00% to 0.03%), and 0.03%, 95% CI: (0.00% to 18.48%), respectively. Compared to CoronaVac, Pfizer, Moderna, AstraZeneca, and Sinopharm had a higher incidence ratio rate (IRR; 22-times, 76-times, 4-times, and 3-times higher), respectively. Likewise, Pfizer, Moderna, and AstraZeneca showed a higher IRR than Sinopharm (7.3-times, 25.3-times, and 1.3-times higher). The current evidence shows that the incidence rate (IR) of cardiac arrhythmia post-COVID-19 vaccination is rare and ranges between 1 and 76 per 10,000. mRNA vaccines were associated with a higher IR of arrhythmia compared to vector-based vaccines. Inactivated vaccines showed the lowest IR of arrhythmia.

Risk of cardiac arrhythmia and cardiac arrest after primary and booster COVID-19 vaccination in England: A self-controlled case series analysis

“…There are also case reports of cardiac arrhythmias occurring after mRNA and adenovirus vectored COVID-19 vaccines, in some cases associated with acute myocarditis, a confirmed signal associated with mRNA vaccines [2] or a pre-existing cardiac disorder [3] , [4] , [5] , [6] . Few COVID-19 vaccine safety studies have evaluated arrhythmia as an outcome, with a recent systematic review finding significant heterogeneity between the limited number of studies where this outcome was reported [7] . For example, one study in England showed no elevated risk after primary immunisation with the mRNA vaccine BNT162b2 in contrast to a study in Malaysia that found a significantly elevated risk within 21 days of a priming dose [8] , [9] .…”

Fake news as systematically distorted communication: an LIS intervention

“…, 2021, p. 590) and now being largely ignored and submerged in the ensuing economic disruptions (Dittert, 2021). The pandemic still generates “immense anger and resentment … at government policies aimed at curbing [it], such as vaccine mandates, school closures and mask requirements” among conservatives (Abutaleb, 2023), drawing on anti-science fake news and producing villains to revile (Sullivan, 2021a). Russia consistently uses fake news explicitly hostile to diversity and liberal democracy in operations and bots to destabilize Ukraine, the US, Europe and in Russia itself to justify its imperial war on Ukraine, forming a tacit alliance with the far right in western democracies (Molina et al.…”

Common pathological findings in the heart in COVID-19-related sudden death cases: An autopsy case series

“…However, it has been associated with severe adverse events, such as permanent left ventricular dysfunction and sudden death [ 4 ]. Additionally, COVID-19 vaccination has been associated with cardiac arrhythmias, with an incidence ranging between 1 and 76 per 10,000 people, with higher ranges for mRNA than for vector-based vaccines [ 14 ]. The mechanisms by which COVID-19 vaccination causes cardiomyopathy and myocarditis are not fully elucidated.…”