Medication unmasked Brugada syndrome and cardiac arrest in a COVID-19 patient

Tsimploulis, Apostolos; Rashba, Eric J.; Rahman, Tahmid; Almasry, Ibrahim; Singh, Abhijeet; Fan, Roger

doi:10.1016/j.hrcr.2020.05.012

Cited by 9 publications

(10 citation statements)

References 16 publications

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“…2 COVID-19 carries arrhythmogenic properties which can unmask or exacerbate cardiac arrhythmias and channelopathies such as long QT syndrome, short QT syndrome and Brugada syndrome (BrS). [3][4][5][6][7] Here we report a case of Brugada ECG pattern during an acute COVID-19 in a patient previously without any identifiable risk factors.…”

Section: Introductionmentioning

confidence: 84%

Brugada pattern in an afebrile patient with acute COVID-19

et al. 2021

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Section: Introductionmentioning

confidence: 84%

Brugada pattern in an afebrile patient with acute COVID-19

et al. 2021

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“…Interestingly, there have even been reports of BrS that have been unmasked by COVID-19 infection. 25…”

Section: Electrocardiographic Manifestations Of Covid-19 Patientsmentioning

confidence: 99%

A review of cardiac involvement in COVID-19 infection

Afshar¹,

Babazadeh²,

Javanian³

et al. 2020

Cor Vasa

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“… 13 , 14 Current data on the hemodynamic effects of dexmedetomidine in CV19 patients is scarce and limited to case reports. 15 , 16…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, patients with CV19 show a high incidence of cardiac manifestations including bradyarrhythmias 13,14 . Current data on the hemodynamic effects of dexmedetomidine in CV19 patients is scarce and limited to case reports 15,16 …”

Section: Introductionmentioning

confidence: 99%

Hemodynamic and respiratory effects of dexmedetomidine sedation in critically ill Covid‐19 patients: A retrospective cohort study

Uusalo

Valtonen

Järvisalo

2021

Acta Anaesthesiol Scand

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Introduction Dexmedetomidine has been suggested to be a promising sedative for patients with Covid‐19 infection (CV19). However, use of dexmedetomidine is limited by its heart rate (HR) and arterial blood pressure lowering effects. Moreover, CV19 is associated with cardiac manifestations including bradyarrythmias. The hemodynamic effects of dexmedetomidine have not been previously studied in CV19 patients. We evaluated the effects of dexmedetomidine on hemodynamic and respiratory parameters of CV19 patients. Methods In this single center study, all CV19 patients receiving dexmedetomidine for sedation during a one year period were included. Our primary outcomes included changes in HR, mean arterial pressure (MAP), respiratory rate (RR), partial oxygen pressure of arterial blood/fraction of inspired oxygen‐ratio (PF‐ratio), and Richmond Agitation and Sedation Score (RASS) during dexmedetomidine administration. Results We identified 39 patients with a mean (SD) age of 58.3 (12.7) years. After initiation of dexmedetomidine, HR decreased by 16.9 (3.3) beats/min (95% CI 9.5–22.4; p < 0.001). During the 12‐hour follow‐up period, HR decrease was significant at 2 to 12 h. Incident bradycardia (<45/min) was reported in 12 (30.8%) patients and it was associated with lower plasma C‐reactive protein, Pro‐calcitonin, and troponin T levels. There was no change in MAP compared to baseline. Dexmedetomidine administration was associated with improvement of PF‐ratio ( p < 0.001) and with decrease of RASS ( p = 0.004). Conclusions Dexmedetomidine is an effective sedative for CV19 patients and may improve their oxygenation. However, dexmedetomidine administration is associated with marked decline in HR and with a high incidence of bradycardia in patients with CV19.

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Medication unmasked Brugada syndrome and cardiac arrest in a COVID-19 patient

Cited by 9 publications

References 16 publications

Brugada pattern in an afebrile patient with acute COVID-19

Brugada pattern in an afebrile patient with acute COVID-19

A review of cardiac involvement in COVID-19 infection

Hemodynamic and respiratory effects of dexmedetomidine sedation in critically ill Covid‐19 patients: A retrospective cohort study

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