Cardiac Arrhythmia after COVID-19 Vaccination versus Non–COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Shi, Ao; Tang, Xiaoyi; Xia, Panpan; Hao, Meiqi; Shu, Yuan; Nakanishi, Hayato; Smayra, Karen; Farzad, Armin; Hu, Kaibo; Liu, Qi; S, Pan; Dixon, Richard A. F.; MBBS, Yue Wu; Cai, Peng; Yu, Peng; Li, Pengyang

doi:10.1101/2022.11.21.22282554

Cited by 4 publications

(5 citation statements)

References 64 publications

(58 reference statements)

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“…The incidence of tachyarrhythmia was significantly higher after COVID-19 vaccination (4367.5 cases per million doses) than after non-COVID-19 vaccination (25.8 cases per million doses). Arrhythmia was also more frequent after the third dose of the COVID-19 vaccine (19,064.3 cases per million doses) than after the first dose (3450.9 cases per million doses) or second dose (2262.5 cases per million doses) [ 29 ].…”

Section: Data From the Literature And Vigilance Databasesmentioning

confidence: 99%

Arrhythmias after COVID-19 Vaccination: Have We Left All Stones Unturned?

Cocco

Leibundgut

Pelliccia

et al. 2023

IJMS

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SARS-CoV-2 vaccination offered the opportunity to emerge from the pandemic and, thereby, worldwide health, social, and economic disasters. However, in addition to efficacy, safety is an important issue for any vaccine. The mRNA-based vaccine platform is considered to be safe, but side effects are being reported more frequently as more and more people around the world become treated. Myopericarditis is the major, but not the only cardiovascular complication of this vaccine; hence it is important not to underestimate other side effects. We report a case series of patients affected by cardiac arrhythmias post-mRNA vaccine from our clinical practice and the literature. Reviewing the official vigilance database, we found that heart rhythm disorders after COVID vaccination are not uncommon and deserve more clinical and scientific attention. Since the COVID vaccine is the only vaccination related to this side effect, questions arose about whether these vaccines could affect heart conduction. Although the risk–benefit ratio is clearly in favor of vaccination, heart rhythm disorders are not a negligible issue, and there are red flags in the literature about the risk of post-vaccination malignant arrhythmias in some predisposed patients. In light of these findings, we reviewed the potential molecular pathways for the COVID vaccine to impact cardiac electrophysiology and cause heart rhythm disorders.

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Section: Data From the Literature And Vigilance Databasesmentioning

confidence: 99%

Arrhythmias after COVID-19 Vaccination: Have We Left All Stones Unturned?

Cocco

Leibundgut

Pelliccia

et al. 2023

IJMS

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“…Moreover, from other analyses, AF resulted in a very rare complication after vaccination. Even if major compared to subjects not vaccinated against COVID-19, the incidence of cardiac arrhythmia following COVID-19 vaccination is very low [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, attention has also shifted to other, even rarer cardiac adverse events, such as AF following mRNA vaccination [ 15 , 19 , 23 , 29 ]. Considering the important impact of this arrhythmia in terms of hospitalization, morbidity, and mortality [ 30 ], data analysis and insights into the possible relationship between AF and COVID-19 vaccination represent an important research topic.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccines and Atrial Fibrillation: Analysis of the Post-Marketing Pharmacovigilance European Database

et al. 2023

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Atrial fibrillation (AF) has been described in COVID-19 patients. Recently, some case reports and US pharmacovigilance analyses described AF onset as a rare adverse event following COVID-19 vaccination. The possible correlation is unclear. We systematically analyzed the reports of AF related to COVID-19 vaccines collected in the European pharmacovigilance database, EudraVigilance (EV), from 2020 to November 2022. We carried out descriptive and disproportionality analyses. Moreover, we performed a sensitivity analysis, excluding the reports describing other possible alternative AF causes (pericarditis, myocarditis, COVID-19, or other drugs that may cause/exacerbate AF). Overall, we retrieved 6226 reports, which represented only 0.3% of all those related to COVID-19 vaccines collected in EV during our study period. AF reports mainly referred to adults (in particular, >65 years old), with an equal distribution in sex. Reports were mainly related to tozinameran (54.04%), elasomeran (28.3%), and ChAdOx1-S (14.32%). The reported AF required patient hospitalization in 35% of cases and resulted in a life-threatening condition in 10% of cases. The AF duration (when reported) was highly variable, but the majority of the events had a short duration (moda = 24 h). Although an increased frequency of AF reporting with mRNA vaccines emerges from our study, other investigations are required to investigate the possible correlation between COVID-19 vaccination and the rare AF occurrence.

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“…The incidence of tachyarrhythmia was significantly higher after COVID-19 vaccination (4367.5 cases per million doses) than after non-COVID-19 vaccination (25.8 cases per million doses). Arrhythmia was also more frequent after the third dose of COVID-19 vaccine (19,064.3 cases per million doses) than after the first dose (3450.9 cases per million doses) or second dose (2262.5 cases per million doses) (28).…”

Section: Data From the Literature And Vigilance Databasesmentioning

confidence: 95%

Arrhythmias after COVID-19 Vaccination: Have We Left All Stones Unturned?

Cocco¹,

Leibundgut²,

Pelliccia³

et al. 2023

Preprint

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-529391451442Citation: To be added by editorial staff during production. Academic Editor: Firstname Lastname Received: date Revised: date Accepted: date Published: date Copyright: © 2023 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).0Citation: To be added by editorial staff during production. Academic Editor: Firstname Lastname Received: date Revised: date Accepted: date Published: date Copyright: © 2023 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Abstract: SARS-CoV-2 vaccination offered the opportunity to get out of the pandemic and thereby worldwide health, social, and economic disasters. However, in addition to efficacy, safety is an important issue for any vaccine. The mRNA-based vaccine platform is considered to be safe but side effects are being reported more frequently as more and more people around the world become treated. Myo-pericarditis is the major, but not the only cardiovascular complication of this vaccine, hence it is important not to underestimate other side effects. We report a case series of patients affected by cardiac arrhythmias post mRNA vaccine from our clinical practice and the literature. Reviewing the official vigilance database emerged that heart rhythm disorders after Covid vaccination are not uncommon and deserve more clinical and scientific attention. Since Covid vaccine is the only vaccination to have been related to this side effect questions arose about whether these vaccines could affect heart conduction. Although the risk-benefit is clearly in favor of vaccination heart rhythm disorders are not a negligible issue and there are red flags in the literature about the risk of post-vaccination malignant arrhythmias in some predisposed patients. In light of these findings, we investigated the potential mechanism for the Covid vaccine to impact on cardiac electrophysiology and cause heart rhythm disorders.

show abstract

Cardiac Arrhythmia after COVID-19 Vaccination versus Non–COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 64 publications

Arrhythmias after COVID-19 Vaccination: Have We Left All Stones Unturned?

Arrhythmias after COVID-19 Vaccination: Have We Left All Stones Unturned?

COVID-19 Vaccines and Atrial Fibrillation: Analysis of the Post-Marketing Pharmacovigilance European Database

Arrhythmias after COVID-19 Vaccination: Have We Left All Stones Unturned?

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