Key result
Lack of COVID-19 vaccination linked to ~8-fold higher ventricular extrasystoles after SARS-CoV-2 infection.
Why the study?
Arrhythmia is believed to be a potential side effect of COVID-19 vaccination, but large-scale studies confirming this relationship are currently lacking.
Does COVID-19 vaccination reduce the occurrence of ventricular and supraventricular extrasystoles on 24-hour Holter ECG monitoring in patients who have recovered from SARS-CoV-2 infection?
Cross-Sectional (n=237)
No
Does COVID-19 vaccination reduce the occurrence of ventricular and supraventricular extrasystoles on 24-hour Holter ECG monitoring in patients who have recovered from SARS-CoV-2 infection?
In patients with prior SARS-CoV-2 infection, lack of COVID-19 vaccination, alongside obesity, hypertension, diabetes, and prior MI, is independently associated with a higher burden of ventricular and supraventricular ectopy on 24-hour Holter monitoring, whereas beta-blockers and ACE inhibitors show a protective association.
Observational data do not justify vaccination recommendations to reduce ectopy; leaves open need for randomized confirmation in post-SARS-CoV-2 patients.
Objectives. Many studies have confirmed the existence of a relationship between SARS-CoV-2 virus infection and an increased incidence of arrhythmia in the population of adults, children and adolescents. It is believed that one of the potential side effects of COVID-19 vaccination is arrhythmia. However, large-scale studies confirming the relationship between COVID-19 vaccination and cardiac arrhythmia are currently lacking. The objective of this study was to analyze the occurrence of arrhythmias in 24 h Holter ECG monitoring among patients who had experienced COVID-19, comparing those who were vaccinated against SARS-CoV-2 with those who were unvaccinated. Methods. The study was performed on a study group of 237 patients, who underwent 24 h Holter monitoring. Results. Ventricular extrasystoles (VEs) were distinctively more common in patients, who had COVID-19 infection and were not vaccinated for COVID-19 comparing to the control group. Similarly, research has shown that supraventricular extrasystoles (SVEs) occurred remarkably more frequently in both unvaccinated and vaccinated patients after COVID-19 infection in relation to control groups. Multivariable regression analysis demonstrates that, in the whole study group, obesity, arterial hypertension, previous myocardial infarction and lack of vaccination against COVID-19 are independent risk factors for higher VE rates. Obesity, diabetes type 2 and lack of vaccination against COVID-19 are independent risk factors for higher SVE rates. The use of β-blockers is an independent protective factor against higher VE and SVE rates, and the use of ACE inhibitors against higher SVE rates. Conclusions. In this study, the authors obtained promising results for the future, facilitating further discussion and research on the topic of the antiarrhythmic advantages of COVID-19 vaccination. Moreover, the knowledge acquired in this study serves as a valuable tool for effectively promoting COVID-19 vaccination among patients.
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Beck et al. (2025) conducted a cross-sectional in Previous SARS-CoV-2 infection with clinical indications for 24 h Holter ECG monitoring (n=237). Lack of COVID-19 vaccination in patients with previous SARS-CoV-2 infection vs. COVID-19 vaccinated patients with previous SARS-CoV-2 infection (n=80) and uninfected controls (n=66) was evaluated on Number of ventricular extrasystoles (VEs) and supraventricular extrasystoles (SVEs) on 24-hour Holter ECG monitoring (p=<0.05). Lack of COVID-19 vaccination in post-SARS-CoV-2 patients was an independent predictor of higher 24-hour ventricular (617.48 vs. 76.40 in controls) and supraventricular extrasystoles (p<0.05).
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