Association between COVID-19 vaccination and atrial arrhythmias in individuals with cardiac implantable electronic devices.

Autor: Deshmukh AJ; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA., Ahmad R; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA., Cha YM; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA., Mulpuru SK; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA., DeSimone CV; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA., Killu AM; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA., Mullane S; BIOTRONIK Inc., Lake Oswego, Oregon, USA., Harrell C; BIOTRONIK Inc., Lake Oswego, Oregon, USA., Kutyifa V; Clinical Cardiovascular Research Center, University of Rochester, Rochester, New York, USA., Cheung JW; Division of Cardiology, Department of Medicine, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, New York, USA., Upadhyay GA; The University of Chicago Medicine, Pritzker School of Medicine, Illinois, USA., Piccini JP; Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA., Hayes DL; BIOTRONIK Inc., Lake Oswego, Oregon, USA., Madhavan M; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2024 Sep; Vol. 35 (9), pp. 1828-1836. Date of Electronic Publication: 2024 Jul 22.
DOI: 10.1111/jce.16372
Abstrakt: Introduction: The impact of mRNA-based coronavirus disease-2019 (COVID-19) vaccines on atrial arrhythmias (AA) and ventricular arrhythmias incidence is unknown.
Methods: BIOTRONIK Home Monitoring data and Medicare Claims data were utilized to identify individuals implanted with a cardiac implantable electronic device (CIED) between 2010 and 2020 who received one or more doses of COVID-19 vaccine in 2021. The burden of AA (%) in the 3 months postvaccination was compared to those noted in the preceding 3 months using the Wilcoxon signed rank test. Sub-analyses comparing the effects of the influenza vaccine against the COVID-19 vaccine were also evaluated for individuals who received the influenza vaccine in 2020. A 1:1 propensity score match comparison between COVID-19 vaccine and non-vaccinated patients was also performed.
Results: First and second doses of the COVID-19 vaccine were administered to 7757 and 6579 individuals with a CIED (age 76.2 ± 9.0 years, 49% males), respectively. While a small but statistically significant increase in the burden of AA was noted in the 3 months postvaccination compared to the preceding 3 months after the first dose of the COVID-19 vaccine (0.43 ± 9.04%, p = .028) a similar rise in AA was found following the influenza vaccine and for matched patients who did not receive the COVID-19 vaccine. No significant difference in device therapies was seen pre- and postvaccination.
Conclusions: Though we report a small but significant increase in the number of CIED-detected AAs following vaccination for COVID-19 over a 3-month window, we believe these results correlate more with time and the progressive nature of AF rather than the vaccine itself. While these data should not dissuade from the use of these vaccines, increased vigilance and prompt treatment of AF is required for high-risk groups, specifically males over 70 years of age, following vaccination.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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