Key result
COVID-19 infection in patients with acute myocardial infarction was associated with a significantly higher rate of life-threatening arrhythmias compared to myocardial infarction alone (24% vs. 5.1%, p=0.026).
Why the study?
The study was conducted to assess parameters of myocardial electrical instability and arrhythmic events using long-term ECG monitoring in post-MI patients comorbid versus noncomorbid with COVID-19.
Does comorbid COVID-19 infection increase myocardial electrical instability and arrhythmic events in patients after myocardial infarction?
Cohort (n=64)
No
Does comorbid COVID-19 infection increase myocardial electrical instability and arrhythmic events in patients after myocardial infarction?
COVID-19 infection in the setting of acute myocardial infarction is associated with increased myocardial electrophysiological heterogeneity and a higher incidence of clinically significant arrhythmias.
Answers are grounded in this paper and cite their sources.
Post-MI patients with COVID-19 warrant intensified arrhythmia surveillance; extends evidence that viral comorbidity heightens electrical instability.
Objective — This article aims to assess parameters of myocardial electrical instability and arrhythmic events in patients after myocardial infarction (MI), with and without ST-segment elevation, comorbid/noncomorbid with a novel coronavirus infection (COVID-19) using a long-term electrocardiographic (ECG) monitoring. Methods — The study included 64 subjects: 25 (39%) patients with MI comorbid with COVID-19 (MI+C group) and 39 (61%) patients with MI noncomorbid with a novel coronavirus infection (MI group). The mean age of patients was 54.3±6.8 years. A long-term ECG monitoring for 97.4 (95% CI 77.9-115.2) hours was performed with Astrocard®-Telemetry system (Meditek JSC, Russia), starting from the 4th day of MI. Rhythm and conduction disorders, along with ischemic episodes were recorded; an analysis of ventricular late potentials, heart rate turbulence, and QT dispersion was carried out. Results — There were no differences in the frequency of delayed afterdepolarizations in MI and MI+C groups: 15-28% and 18-33% of patients, respectively. An analysis of turbulence parameters did not reveal statistically significant differences between the groups. Such arrhythmic events as frequent supraventricular extrasystole and life-threatening arrhythmias (ventricular extrasystole of grade 4A and higher sensu B. Lown and M. Wolf) were recorded significantly more often in the MI+C group than in the MI group: 48% vs. 20.5% (p=0.021) and 24% vs. 5.1% (p=0.026), respectively. Conclusion — The novel coronavirus infection (COVID-19) exacerbates myocardial electrophysiological heterogeneity in the acute cardiovascular event and is associated with an increase in clinically significant arrhythmic events.
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Tonkoglaz et al. (2022) conducted a cohort in Myocardial Infarction (n=64). COVID-19 infection vs. Myocardial infarction without COVID-19 was evaluated on Life-threatening arrhythmias (ventricular extrasystole of grade 4A and higher) (p=0.026). COVID-19 infection in patients with acute myocardial infarction was associated with a significantly higher rate of life-threatening arrhythmias compared to myocardial infarction alone (24% vs. 5.1%, p=0.026).
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