CE-541-04 CARDIAC ARRHYTHMIAS IN POST-ACUTE SEQUELAE OF SARS-COV-2 INFECTION ASSESSED BY AMBULATORY RHYTHM MONITORING

Abstract

Many COVID-19 survivors report ongoing cardiopulmonary symptoms and organ dysfunction in a poorly understood syndrome known as post-acute sequelae of COVID-19 (PASC). Risk of arrhythmias is elevated in acute COVID-19 infection, especially in hospitalized patients with severe infection. In the post-acute period, palpitations are commonly reported, but little is known about the risk of arrhythmias in patients with PASC. To characterize the burden of arrhythmias in individuals with PASC at least 1 year after SARS-CoV-2 infection and the correlation between symptoms and clinically significant arrhythmias. As part of the LIINC COVID-19 recovery cohort (NCT04362150), we conducted ambulatory rhythm monitoring using the Bardy Diagnostics Carnation Ambulatory Monitor (CAM) for up to 14 days on participants at least 1 year after PCR-confirmed COVID-19 infection without prior CVD. Cardiopulmonary symptoms were assessed through interviews at the time of enrollment, at the time of initiation of rhythm monitoring, and through a journal used during the rhythm monitoring period. Among 27 participants, 13 reported cardiopulmonary symptoms. Median age was 56 and 48% were female (Table 1); monitoring was performed at a median of 16.5 months after infection. Those with PASC pushed the symptom button 4.2 more times on average (95% CI -1.4 to 10.3; p=0.13). After adjustment for age and sex, cardiopulmonary symptoms were not associated with an increased burden of PACs (β = -0.04, 95%CI -0.15 to 0.07, p = 0.47), PVCs (β = 0.21, 95%CI -0.22 to 0.65, p = 0.31), or supraventricular tachycardia episodes (β = 3.0 per week, 95%CI -3.1 to 9.2, p = 0.31). Average HR (β = -1.66, 95%CI -12.8 to 9.5, p = 0.076) and HR variability (β = 2.5, 95%CI -10.3 to 15.3, p = 0.69) were not significantly different between those with and without symptoms. Similar results were found after adjusting for LVEF, LV strain, and LA volume index. Button pushes correlated with SVT in only one participant who had PASC and none without PASC. In the first study to assess cardiac arrhythmia burden in patients with PASC through ambulatory rhythm monitoring, we did not find significant associations between the presence of cardiopulmonary symptoms after COVID-19 and PAC burden, PVC burden, SVT episodes, average HR, or HR variability.