Cardiac arrhythmias in patients with COVID-19: Lessons from 2300 telemetric monitoring days on the intensive care unit
| Autor: | Ulf Landmesser, Tim Guthof, Karl Stangl, Theresa Keller, Sebastian Biewener, Verena Tscholl, Martin Huemer, Stefan Angermair, Philipp Attanasio, Abdul Shokor Parwani, Paul Kamieniarz, Florian Blaschke, Sascha Treskatsch, Holger Müller-Redetzky, Marcel Haug, Burkert Pieske, Daniel Zieckler, Leif-Hendrik Boldt, Jan Kruse |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Tachycardia
medicine.medical_specialty Defibrillation medicine.medical_treatment 030204 cardiovascular system & hematology Cardioversion Ventricular tachycardia Article law.invention Electrocardiography 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Humans Intensive care unit Sars cov 2 cardiovascular diseases 030212 general & internal medicine Aged medicine.diagnostic_test SARS-CoV-2 business.industry COVID-19 Arrhythmias Cardiac Atrial fibrillation Middle Aged medicine.disease Intensive Care Units Ventricular fibrillation cardiovascular system Cardiology RNA Viral Female medicine.symptom Cardiology and Cardiovascular Medicine business Telemetric ECG monitoring |
| Zdroj: | Journal of Electrocardiology |
| ISSN: | 0022-0736 |
| Popis: | BACKGROUND: Patients with COVID-19 seem to be prone to the development of arrhythmias. The objective of this trial was to determine the characteristics, clinical significance and therapeutic consequences of these arrhythmias in COVID-19 patients requiring intensive care unit (ICU) treatment. METHODS AND RESULTS: A total of 113 consecutive patients (mean age 64.1 ± 14.3 years, 30 (26.5%) female) with positive PCR testing for SARS-CoV2 as well as radiographically confirmed pulmonary involvement admitted to the ICU from March to May 2020 were included and observed for a cumulative time of 2321 days. Fifty episodes of sustained atrial tachycardias, five episodes of sustained ventricular arrhythmias and thirty bradycardic events were documented. Sustained new onset atrial arrhythmias were associated with hemodynamic deterioration in 13 cases (35.1%). Patients with new onset atrial arrhythmias were older, showed higher levels of Hs-Troponin and NT-proBNP, and a more severe course of disease. The 5 ventricular arrhythmias (two ventricular tachycardias, two episodes of ventricular fibrillation, and one torsade de pointes tachycardia) were observed in 4 patients. All episodes could be terminated by immediate defibrillation/cardioversion. Five bradycardic events were associated with hemodynamic deterioration. Precipitating factors could be identified in 19 of 30 episodes (63.3%), no patient required cardiac pacing. Baseline characteristics were not significantly different between patients with or without bradycardic events. CONCLUSION: Relevant arrhythmias are common in severely ill ICU patients with COVID-19. They are associated with worse courses of disease and require specific treatment. This makes daily close monitoring of telemetric data mandatory in this patient group. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect