Table 1.

Arrhythmias in COVID-19. Incidence data based on available prospective and retrospective cohort data cited in text. AV: atrioventricular; AF/AFL: atrial fibrillation/atrial flutter; CCB: calcium channel blocker; BB: beta blocker; SVT: supraventricular tachycardia; AVN: atrioventricular node; PVCs: premature ventricular contractions; AADs: antiarrhythmic drugs; NSVT: nonsustained ventricular tachycardia; TdP: torsade de pointes; POTS: postural orthostatic tachycardia syndrome; ICD: implantable cardioverter defibrillator; IST: inappropriate sinus tachycardia

TYPE	REPORTED INCIDENCE (%)	COMMENTS	MANAGEMENT STRATEGIES
Sinus tachycardia	40-55%	Most common, appropriate in acute setting	COVID-19–directed treatment
Sinus bradycardia	5-25%	Likely a poor prognostic marker	Avoid AV nodal blockade Avoid dexmedetomidine if possible Temporary or permanent pacing if profound and unstable
AF/AFL	2-12%	Most common pathologic arrhythmia, poor prognostic marker	Rate/rhythm control strategies CCBs preferred over BBs to minimize bronchospasm
SVT	0.6-6%		Usual care with adenosine, AVN blockers, and cardioversion if unstable
PVCs	0-28%		No evidence for prophylactic AADs
NSVT	0-15%		No evidence for prophylactic AADs
Sustained VT/VF or TdP	0-1.4%	Usually only in critical illness	Defibrillation and AADs VT catheter ablation if AADs not tolerated ICDs for secondary prevention though unclear long-term benefit
AV block	0-1.4%	Usually only in critical illness, unclear if reversible	Temporary or permanent pacing
POTS	4-22%	Reported in the convalescent period due to dysautonomia	Nonpharmacologic: compression stockings, salt intake, exercise Pharmacologic: mineralocorticoids, alpha agonists, BBs, ivabradine
IST	3-4%	Reported in the convalescent period due to dysautonomia	BBs, ivabradine