Open AccessCardiac arrhythmias in patients with COVID‐19
Author(s) -
Wang Yueying,
Wang Zhaojia,
Tse Gary,
Zhang Lin,
Wan Elaine Y.,
Guo Yutao,
Lip Gregory Y. H.,
Li Guangping,
Lu Zhibing,
Liu Tong
Publication year - 2020
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12405
Subject(s) - medicine , hydroxychloroquine , covid-19 , azithromycin , cardiology , cardiac arrhythmia , adverse effect , coronavirus , long qt syndrome , intensive care medicine , torsades de pointes , qt interval , sudden cardiac death , repolarization , disease , atrial fibrillation , infectious disease (medical specialty) , electrophysiology , microbiology and biotechnology , biology , antibiotics
The emergence of coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has become a major global public health concern. Although SARS‐CoV‐2 causes primarily respiratory problems, concurrent cardiac injury cannot be ignored since it may be an independent predictor for adverse outcomes. Cardiac arrhythmias are often observed in patients with COVID‐19, especially in severe cases, and more likely contribute to the high risk of adverse outcomes. Arrhythmias should be regarded as one of the main complications of COVID‐19. Mechanistically, a number of ion channels can be adversely affected in COVID‐19, leading to alterations in cardiac conduction and/or repolarization properties, as well as calcium handling, which can predispose to cardiac arrhythmogenesis. In addition, several antimicrobials that are currently used as potential therapeutic agents for COVID‐19, such as chloroquine, hydroxychloroquine and azithromycin, have uncertain benefit, and yet may induce electrocardiographic QT prolongation with potential ventricular pro‐arrhythmic effects. Continuous electrocardiogram monitoring, accurate and prompt recognition of arrhythmias are important. The present review focuses on cardiac arrhythmias in patients with COVID‐19, its underlying mechanisms, and proposed preventive and therapeutic strategies.