Covid19 Clinical Trial
Official title:
Patterns of Arrhythmias and Conduction Block in COVID-19 Patients and Its Relation to Myocardial Injury Detected by Cardiac Magnetic Resonance
Detection of the incidence and types of arrhythmia and conduction block in COVID - 19 patients Detection and description of CMR patterns of myocardial injury in COVID-19 patients with arrhythmias.
COVID-19 has been declared a global pandemic by the World Health Organization and is
responsible for hundreds of thousands of deaths worldwide.
Early reports from China suggested an overall cardiac arrhythmia incidence of 17% in patients
hospitalized for COVID-19. A higher arrhythmia rate (44%) was observed in patients with
COVID-19 admitted to the intensive care unit (ICU). However, details of the type and burden
of arrhythmias in this population have not been elucidated.
Myocardial injury is common in patients with COVID-19, accounting for 7%-23% of reported
cases in Wuhan, China. Among COVID-related myocardial injury, etiologies vary and can include
myocarditis, myocardial infarction, sepsis-related myocardial injury, and/or stress induced
cardiomyopathy. Myocardial injury is associated with high risk of developing all types of
arrhythmia including atrial fibrillation, supraventricular tachycardia, ventricular
tachycardia, ventricular fibrillation, and variable degrees of heart block. Sudden cardiac
death was also reported.
The pathophysiology of COVID-19-related myocarditis is a combination of direct viral injury
and cardiac damage due to the host's immune response. Although the pathophysiology of
arrhythmias is still speculative, clinicians should provide prompt monitoring and treatment.
The long term impact of COVID-19 myocarditis remains unknown
Meanwhile, cardiac magnetic resonance (CMR) imaging is an integral test in the diagnosis of
myocardial injury. It can safely be used as a first-line diagnostic tool in the workup of
myocardial injury associated with COVID-19.
Investigators believe that proper diagnosis and management of COVID 19 related arrhythmias
and their etiology can lead to both in-hospital and long term reduction of morbidity and
mortality of this dangerous presentation of the disease.
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