Table 1.
Cardiac arrhythmias in RNA viruses
| Virus | Author, year, country | Study design | Sample size (n) | Notable arrhythmias | Reported myocarditis (%) |
|---|---|---|---|---|---|
| Dengue | Poornima 2019, India | Retrospective observational | 341 |
Sinus bradycardia (8.79%) T wave inversion (4.1%) AF (2.93%) AV block (2.34%) ST depression (2.3%) |
N/A |
| Shah 2020, India | Prospective observational | 320 |
Sinus bradycardia (19.7%) Sinus tachycardia (6.9%) AF (3.75%) VT (0.60%) |
17.5 (no CMRI nor biopsy done) | |
| CHIKV | Carta 2018, Venezuela | Prospective observational | 287 |
Bradyarrhythmia (33%) AF (6.6%) |
N/A |
| Villamil-Gómez 2016, Colombia | Case series | 42 |
1st degree AV block (19%) Left anterior hemiblock (9.5%) Bradyarrhythmia (7.1%) AF (2.4%) Tachyarrhythmias (4.8%) |
“Suspected in all” | |
| Dengue/CHIKV | Obeyeskere 1973, Sri Lanka | Case series | 35 |
Frequent ventricular ectopy (31.4%) Sinus tachycardia (17.1%) AF (2.8%) Transient complete AV dissociation (2.8%) VT (2.8%) |
100 a |
| Zika | Mendoza 2018, unknown location | Prospective observational | 16 |
Complex ventricular arrhythmias (62.5%) Non-sustained atrial tachycardia (62.5%) AF (43.8%) VT (31.3%) |
100 |
| Villamil-Gómez 2018, Colombia | Case series | 2 |
Sinus tachycardia with prolonged Qtc (50%) Left anterior hemiblock (50%) |
N/A | |
| SARS-CoV-2 | Rosenblatt 2022, USA | Retrospective database | 30,999 | AF (5.4%) | N/A |
| Li 2021, N/A | Meta-analysis of 19 studies | 21,653 | AF (11%) | N/A | |
| Bhatla 2020, USA | Retrospective observational | 700 |
AF (3.6%) Non-sustained VT (1.4%) Clinically significant bradyarrhythmia (1.3%) |
N/A | |
| Cho 2020, united states | Prospective observational | 143 |
Sinus tachycardia (39.9%) Non-sustained VT (15.4%) Sustained VT (1.4%) VF (0.7%) |
N/A | |
| Coxsackie B Virus | Multiple | Case reports | Ventricular arrhythmias | N/A | |
| Influenza A | Madjid 2019, USA | Retrospective observational | 163,831 | Ventricular arrhythmias requiring shock or antitachycardia pacing increased during periods of high and moderate influenza activity | N/A |
| Chang 2016, Taiwan | Retrospective case–control | 56,870 | AF (18% increase in risk) compared to control group | N/A | |
| Ukimura 2010, Japan | Case series | 15 |
VF (26.7%) Complete AV block (26.7%) SVT (13.3%) AF (13.3%) |
100 | |
| Rubella | Multiple | Case reports | AV block | N/A | |
| HIV | Abudan 2020, USA | Retrospective database | 2,370,751 |
AF (2110†) VT (560†) Atrial flutter (420†) SVT (170†) VF (130†) |
N/A |
| Park 2022, USA | Meta-analysis of 7 studies | 94,928 | Atrial arrhythmia (6.4 cases per 1000 person years); 35% greater than those without HIV | N/A |
aDiagnostic criteria used: (1) clinical evidence of myocarditis; (2) presence of electrocardiographic evidence of myocarditis, ST segment and T wave changes, and disturbances in conduction and rhythm; (3) recent history of “dengue-like” fever; (4) serological evidence of past dengue or chikungunya infection as revealed by the presence of antibody in high titers
†Per 100,000 hospitalizations