DOI: 10.1161/circ.148.suppl_1.13351 ISSN: 0009-7322

Abstract 13351: Impact of a Second Incident Arrhythmia on Outcomes in Hospitalized COVID-19 Patients: Insights From the COVID-RHYTHM Registry

Adnan Ahmed, Danish Bawa, Rishi Charate, Andrea M Russo, Jaimin Trivedi, Elaine Y Wan, Philip L Mar, Rajesh Kabra, Sandeep Gautam, Stavros Stavrakis, Tolga Aksu, Sandeep A Saha, Zhenguo Liu, Paari Dominic, Zain Ul Abideen U Asad, Deepak Padmanabhan, Jayaprakash Shenthar, Amin Al-Ahmad, Andrea Natale, Dhanunjaya Lakkireddy, Rakesh Gopinathannair
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Incident cardiac arrhythmias are common in hospitalized COVID-19 patients, but the impact of a second incident cardiac arrhythmia during hospitalization on clinical outcomes remain unclear.

Hypothesis: The aim of this study was to assess the frequency and prognostic implications of a second incident arrhythmia in hospitalized COVID-19 patients over the pandemic course till vaccine availability.

Methods: The multicenter COVID-RHYTHM Registry enrolled hospitalized COVID-19 patients from 3/8/2020 to 1/24/2021. Cardiac arrhythmia included documented atrial fibrillation (AF), atrial flutter (AFL), ventricular tachycardia (VT), severe sinus bradycardia (<40 bpm) or AV block. Outcomes were compared between patients with single vs. more than one incident arrhythmias adjusting for baseline variables.

Results: Of 6299 hospitalized COVID-19 patients, 4398 had an had an incident cardiac arrhythmia during hospitalization, of which 822 (19%) had a second incident arrhythmia. Those with >1 incident arrhythmia had a higher baseline prevalence of heart failure, chronic kidney disease, coronary artery disease and sleep apnea (Table). Those with >1 incident arrhythmia had higher in-hospital mortality, need for ICU admission and need for rehab upon discharge. Length of stay was similar between the groups.

Conclusions: In hospitalized COVID-19 patients with incident cardiac arrhythmias, a second incident arrhythmia during hospitalization was seen in 19%. Having >1 incident arrhythmia was associated with increased need for ICU admission and reduced survival.

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