Abstract 112 Incidence and predictors of cardiac arrhythmias in patients with COVID-19 induced ARDS

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Incidence and predictors of cardiac arrhythmias in patients with COVID-19 induced ARDS
P. Niehues¹, F. K. Wegner¹, J. Wolfes¹, K. Willy¹, C. Ellermann¹, R. Vollenberg², F. Rosenow³, J. Lepper³, J. Sackarnd³, L. Eckardt¹
¹Klinik für Kardiologie II - Rhythmologie, Universitätsklinikum Münster, Münster; ²Medizinische Klinik B (Gastroenterologie, Hepatologie, Endokrinologie, Klinische Infektiologie), Universitätsklinikum Münster, Münster; ³Klinik für Kardiologie I: Koronare Herzkrankheit, Herzinsuffizienz und Angiologie, Universitätsklinikum Münster, Münster;
Introduction: Recent studies suggest cardiac involvement and myocardial damage in the setting of COVID-19. In this context, increased incidence of arrhythmias has been described in patients with severe disease requiring intensive care treatment. The aim of this study was to evaluate the risk of arrhythmias in a relatively young and previously healthy population with COVID-19 induced acute respiratory distress syndrome (ARDS) and to elicit possible predictors of arrhythmia occurrence. Methods and Results: 107 consecutive patients (82 male, mean age 60 ± 12 years, median BMI 28 kg/m²) treated for COVID-19 induced ARDS in our university hospital intensive care unit between March 2020 and February 2021 were retrospectively analyzed. 84 patients (79%) had at least moderate ARDS, 88 patients (83%) were mechanically ventilated, 35 patients (33%) received veno-venous extracorporeal membrane oxygenation therapy and 43 patients (40%) died during their hospital stay. Twelve patients (11%) showed potentially lethal arrhythmias (6 sustained monomorphic ventricular tachycardia, 3 complete atrioventricular block, 2 asystole, 1 significant sinus bradycardia). An episode of atrial fibrillation occurred in 27 patients (25%). In a multivariate logistic regression analysis, duration of hospitalization stay was associated with the occurrence of potentially lethal arrhythmias (p=0.006). There was no association between possible predictive factors and the occurrence of atrial fibrillation. Invasive ventilation, antipsychotics and the QTc interval were independently associated with acute in-hospital mortality, but this was not arrhythmia-driven as there was no association between the occurrence of potentially lethal arrhythmias and mortality. Conclusion: In this relatively young population with COVID-19 induced ARDS, incidence of potentially lethal arrhythmias was low. While overall mortality was high in these severely affected patients, cardiac involvement and arrhythmia occurrence did not seem to be a significant driver of mortality. P.N. and F.K.W. contributed equally.
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