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Review
. 2023 Jan 3;11(1):112.
doi: 10.3390/vaccines11010112.

Risks of Cardiac Arrhythmia Associated with COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Mohammed H Abutaleb  1 , Hafiz A Makeen  2 , Abdulkarim M Meraya  2 , Saad S Alqahtani  2 , Bayan Ibrahim Al-Mass  3 , Reaam Omar Aljazaeri  4 , Bushra Dhuhayyan Alhazmi  5 , Afnan Mohammed Noor Kalakattawi  6 , Ahmed Ali Alajam  7
Affiliations
Review

Risks of Cardiac Arrhythmia Associated with COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Mohammed H Abutaleb et al. Vaccines (Basel). .

Abstract

This systematic review and meta-analysis aimed to summarize the current evidence regarding the association between coronavirus disease 2019 (COVID-19) vaccination and the risk of cardiac arrhythmia. MEDLINE, via PubMed and OVID, Scopus, CENTRAL, and Web of Science were searched using the relevant keywords to identify the relevant citations. Comprehensive Meta-analysis and Review Manager 5.4.1 were used for all the statistical analyses. Seventeen studies (n = 567,033,087 patients) were included. The pooled analysis showed that the incidence of cardiac arrhythmia post-COVID-19 vaccination with Pfizer, Moderna, AstraZeneca, CoronaVac, and Sinopharm was 0.22%, 95% CI: (0.07% to 0.66%), 0.76%, 95% CI: (0.04% to 12.08%), 0.04%, 95% CI: (0.00% to 0.98%), 0.01%, 95% CI: (0.00% to 0.03%), and 0.03%, 95% CI: (0.00% to 18.48%), respectively. Compared to CoronaVac, Pfizer, Moderna, AstraZeneca, and Sinopharm had a higher incidence ratio rate (IRR; 22-times, 76-times, 4-times, and 3-times higher), respectively. Likewise, Pfizer, Moderna, and AstraZeneca showed a higher IRR than Sinopharm (7.3-times, 25.3-times, and 1.3-times higher). The current evidence shows that the incidence rate (IR) of cardiac arrhythmia post-COVID-19 vaccination is rare and ranges between 1 and 76 per 10,000. mRNA vaccines were associated with a higher IR of arrhythmia compared to vector-based vaccines. Inactivated vaccines showed the lowest IR of arrhythmia.

Keywords: COVID-19; arrhythmia; incidence; meta-analysis; vaccine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
The RR of arrhythmia post-Pfizer COVID-19 vaccine compared to Moderna.
Figure 3
Figure 3
The RR of arrhythmia post-Pfizer COVID-19 vaccine compared to AstraZeneca.
Figure 4
Figure 4
The RR of arrhythmia post-AstraZeneca COVID-19 vaccine compared to Moderna.
Figure 5
Figure 5
The RR of arrhythmia post-Pfizer COVID-19 vaccine compared to CoronaVac.
See this image and copyright information in PMC

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