Journal of Cardiovascular Electrophysiology, Год журнала: 2024, Номер 35(9), С. 1837 - 1838
Опубликована: Авг. 22, 2024
In the wake of coronavirus disease 2019 (COVID-19) pandemic, accelerated research and development efforts were made to create a new class vaccinations mitigate unprecedented global health burden. However, rapid approval process was factor in prompting vaccine hesitancy, based partially on concerns regarding safety vaccine. Adding reports adverse reactions became widely disseminated medical literature, as well social media. lack long-term data controlled studies have limited interpretation true COVID-19 risk profile, has hampered effort combat misinformation. Cardiac complications are most frequently reported reaction following vaccination.1 Case series attributed exacerbations various chronic cardiac diseases vaccination, including hypertension, coronary artery disease, arrhythmias.2 WHO database, palpitation tachycardia across all age groups gender many cases atrial fibrillation.2 The Vaccine Adverse Event Report System (VAERS) database Food Drug Administration over 2600 fibrillation only 315 which new-onset.3 These reports, however, generally anecdotal, denominators not considered, causality cannot be inferred. Any association is further confounded when evaluating vaccine's effects populations whom cardiovascular common comorbidity, prevalence heart rhythm abnormalities already high. this circumstance, patients clinicians may tend inappropriately attribute an arrhythmia occurrence history vaccination. Indeed, majority outcomes that occur vaccination little do with itself, even temporal relationship suggestive. Tachycardia arrhythmias inflammatory or stress-related response Inflammatory such myocarditis pericarditis been shown at higher rates vaccination.4 A potential mechanism post-COVID-19 events immune detection mRNA antigen, particularly genetically predisposed individuals; these cases, immunization activate cascades, leading systemic potentially ventricular arrhythmias.5 Atrial long associated conditions, relatively myocarditis.6 Accordingly, increase burden after biologically plausible, regardless whether itself pro-arrhythmic. For practicing cardiologists, can reasonably considered disorder pandemic proportions. Driven by both modifiable non-modifiable factors, more ubiquitous screening modalities, incidence AF 31% 2017 compared 1997, predictive models suggest will impact nearly 8 million Americans 2050.7, Furthermore, progressive least 25% patients, progression from paroxysmal persistent 8%–15% per year.9 interventions, particular ablation, reduce rate markedly.10 Though increasing individual patient natural factors commonly implicated drivers progression. Interestingly, also contributed AF, we high two-thirds onset, large numbers hospitalized COVID-19.11 who identification extrinsic novel contribute directly onset challenging, non-randomized misleading due unrecognized confounders. study issue Journal Cardiovascular Electrophysiology Deshmukh et al,12 extracted retrospectively databases CIEDs, evaluate any between Insurance claims used identify receiving trends burden, occurring before analyzed, similar undergoing found 3 months increases observed did receive same time frame, sustained noted course year, populations. findings implicate progression, primary driver This manuscript's first conclusion citing males 70 years highest, therefore misleading, subsequently comparison matched vaccinated unvaccinated yielded no statistically significant difference best understood devices capable monitoring. Beyond predicted time, time. demonstrates trend population underlying they had not. Exacerbations fibrillation, seen vaccinations, in-part related induced response. study, appear accelerate quickly received relative those get vaccinated, burdens versus benefit analysis must always performed therapy, vaccines. While does report benefits vaccine, it provide some reassurance recommending our for arrhythmias, infection. nature highest AF-related morbidity mortality, justifies current towards early intervention. Data sharing applicable article datasets generated analyzed during study.
Язык: Английский