The following is a summary of “Impact of a Second Incident Arrhythmia on Outcomes in Hospitalized COVID-19 Patients: Insights From the COVID-RHYTHM Registry,” published in the November 2023 issue of Cardiology by Ahmed et al.

While prevalent in hospitalized COVID-19, the impact of repeat cardiac arrhythmias during stay on clinical outcomes is unknown.

Researchers conducted a retrospective study to track the frequency and prognostic significance of repeat cardiac arrhythmias in hospitalized COVID-19 patients during the pandemic period leading up to vaccine availability.

They enrolled hospitalized COVID-19 patients (3/8/2020 to 1/24/2021) in the multicenter COVID-RHYTHM Registry. Cardiac arrhythmia, encompassing documented atrial fibrillation (AF), atrial flutter (AFL), ventricular tachycardia (VT), severe sinus bradycardia (<40 bpm), or AV block, was assessed. Outcomes were compared, adjusting for baseline variables, between patients with a single incident arrhythmia and those with more than one incident arrhythmia.

The results showed that of 6,299 COVID-19 patients who were admitted, 4,398 encountered an incident cardiac arrhythmia, with 822 (19%) experiencing a second incident arrhythmia. Individuals with multiple arrhythmia incidents showed elevated baseline rates of heart failure, chronic kidney disease, coronary artery disease, and sleep apnea. Furthermore, this group showed higher in-hospital mortality, increased chances of ICU admission, and a greater need for rehabilitation upon discharge. The duration of hospital stay was common between the two groups.

Investigators concluded that pre-vaccine COVID-19 patients with one arrhythmia had a 19% risk of a second, linked to more ICU needs and lower survival.

Source: ahajournals.org/doi/10.1161/circ.148.suppl_1.13351