Key result
COVID-19 is linked to diverse rhythm and conduction disorders driven by inflammation and myocardial injury.
Why the study?
COVID-19 is associated with a broad spectrum of rhythm and conduction disorders, but the absolute risk and contribution of direct viral myocardial injury remain incompletely defined.
Arrhythmias in COVID-19 reflect the interplay between systemic illness and myocardial injury, emphasizing the need to correct reversible triggers acutely and manage subsequent arrhythmias according to established cardiology guidelines.
Supports arrhythmia vigilance during and after COVID-19; leaves open precise long-term risks and mechanism-targeted trials.
COVID-19 is associated with a broad spectrum of rhythm and conduction disorders, particularly among hospitalized and critically ill patients. Arrhythmogenesis is multifactorial and reflects systemic inflammation, hypoxaemia, myocardial ischaemia or injury, myocarditis, autonomic imbalance, thromboembolic disease, electrolyte disturbances and drug-related proarrhythmia. Atrial fibrillation is the most frequently reported sustained arrhythmia, while ventricular tachyarrhythmias, bradyarrhythmias and atrioventricular conduction disturbances occur predominantly in patients with severe disease or myocardial injury. Contemporary population-based evidence also indicates that arrhythmic risk may persist beyond the acute infection, although the absolute risk and the contribution of direct viral myocardial injury remain incompletely defined. This review summarizes the principal mechanisms, clinical phenotypes and management considerations of COVID-19-related arrhythmias and highlights emerging evidence concerning post-acute autonomic dysfunction and long-term rhythm complications.
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Iovchev et al. (2026) conducted a review in COVID-19-related arrhythmias and conduction disorders. COVID-19 infection was evaluated. COVID-19 is associated with a broad spectrum of rhythm and conduction disorders driven by multifactorial mechanisms including systemic inflammation, myocardial injury, and autonomic imbalance.
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