DISORDERS OF HEART RHYTHM IN THE POST-COVID PERIODS
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14091Keywords:
coronavirus disease, myocarditis, arrhythmia, Holter ECG monitoringAbstract
SUMMARY. The spectrum of possible COVID-19-associated cardiac arrhythmias is broad, ranging from benign ventricular extrasystoles to atrial fibrillation and sudden cardiac death from ventricular arrhythmias, most likely due to various pathomechanisms. Atrial fibrillation is one of the most common cardiovascular disorders and shares similar comorbidities with patients suffering from post-COVID syndrome. Arrhythmias after Covid-19 require in-depth study, as they often worsen the patient's quality of life and pose a threat to his life.
The aim – to analyze scientific sources on cardiac arrhythmias during coronavirus infection and highlight our own clinical observation related to the diagnostic aspects of detecting complex rhythm disturbances that persist in the patient in the post-epidemic period. Clinicians need to focus upon the cardiovascular system of COVID-19 patients and treat them in a timely manner to avoid the adverse consequences caused by cardiovascular complications.
Material and methods. Literary publications highlighting possible clinical variants of cardiac complications in COVID-19 were analyzed, and heart rhythm disturbances of a patient after suffering from COVID-19 were interpreted based on the results of Holter ECG monitoring using the multi-functional electrocardiographic complex ECG-pro (IMESC).
Results. The article presents a clinical case of arrhythmia in a 51-year-old male due to the COVID-19-associated myocarditis. In 2020, the diagnosis was proved by the laboratory and MRI signs of active inflammatory process in the myocardium. The anti-inflammatory and anticoagulant therapy was prescribed. 2,5 years later Holter ECG monitoring revealed different supraventricular and ventricular rrhythm disorders: a paroxysmal form of atrial fibrillation and atrial flutter during 30 % of the observation time, frequent polytopic premature atrial and ventricular contractions. The cardiac arrhythmia was considered as a consequence of the previous COVID-19-associated myocarditis, and anticoagulant and antiarrhythmic therapy was prescribed.
Conclusions. An increase in the number of people who have suffered an infection increases the number of individuals with post-COVID symptoms. Cardiac arrhythmias are some of the most relevant manifestations of this condition and lead to a significant impairment of the quality of life. The spectrum of cardiac arrhythmias in post-COVID patients is wide and variant, probably due to different pathological mechanisms that need further exploration. Cardiac arrhythmia screening in symptomatic patients is required to make the correct diagnosis and provide patients with adequate therapy.
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