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Comment
. 2021 Nov;44(11):1939-1943.
doi: 10.1111/pace.14321. Epub 2021 Jul 28.

Reversible complete heart block in a patient with coronavirus disease 2019

Varun Bhasin  1 , MaryKate Carrillo  1 , Bobby Ghosh  1 , Danyaal Moin  1 , Theodore J Maglione  1 , John Kassotis  1
Affiliations
Comment

Reversible complete heart block in a patient with coronavirus disease 2019

Varun Bhasin et al. Pacing Clin Electrophysiol. 2021 Nov.

Abstract

Patients infected with novel coronavirus (SARS-CoV-2) can present with a variety of arrhythmias. We report an unusual case of reversible complete heart block (CHB) in the setting of acute coronavirus disease 2019 (COVID-19). A 23-year-old male with a history of Hodgkin's Lymphoma presented with dizziness and syncope. He was found to be in CHB associated with hypotension requiring a transvenous pacemaker. Methylprednisolone and remdesivir were started with rapid resolution of the CHB. Further study is needed to determine the mechanism of CHB in COVID-19. This case underscores the importance of including COVID-19 in one's differential diagnosis for acute CHB.

Keywords: COVID-19; arrhythmia; complete heart block; myocarditis; transvenous pacing.

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Conflict of interest statement

No conflict of interest to be reported.

Figures

FIGURE 1
FIGURE 1
Initial EKG on presentation to emergency department [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
12 Lead EKGs. (A) Transition to complete heart block, (B) Sinus rhythm with complete heart block (sinus rate 140, ventricular escape 58), (C) Baseline EKG (2 weeks prior to presentation) showing sinus tachycardia, HR 101 [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Left heart catheterization and transthoracic echocardiogram [Colour figure can be viewed at wileyonlinelibrary.com] (A) Left heart catheterization with angiographically normal coronaries (B) Initial transthoracic echocardiogram on hospital day 1
See this image and copyright information in PMC

Comment on

  • Bradyarrhythmias in patients with COVID-19: Marker of poor prognosis?
    Chinitz JS, Goyal R, Harding M, Veseli G, Gruberg L, Jadonath R, Maccaro P, Gandotra P, Ong L, Epstein LM. Chinitz JS, et al. Pacing Clin Electrophysiol. 2020 Oct;43(10):1199-1204. doi: 10.1111/pace.14042. Epub 2020 Sep 14. Pacing Clin Electrophysiol. 2020. PMID: 32820823 Free PMC article.

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