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Multicenter Study
. 2023 Jun;34(6):1386-1394.
doi: 10.1111/jce.15929. Epub 2023 May 17.

Incidence of ventricular arrhythmias related to COVID infection and vaccination in patients with Brugada syndrome: Insights from a large Italian multicenter registry based on continuous rhythm monitoring

Michela Casella  1   2 , Sergio Conti  3 , Paolo Compagnucci  1   4 , Valentina Ribatti  5 , Maria Lucia Narducci  6 , Lorenzo Marcon  5 , Francesca Massara  1 , Yari Valeri  1 , Luca De Francesco  6 , Anna Maria Martino  7 , Chiara Ghiglieno  8 , Marco Schiavone  9 , Cristina Balla  10 , Gabriele Dell'Era  8 , Gemma Pelargonio  6 , Giovanni Battista Forleo  9 , Saverio Iacopino  11 , Giuseppe Sgarito  3 , Leonardo Calò  7 , Claudio Tondo  5   12 , Antonio Dello Russo  1   4 , Giuseppe Patti  8
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Multicenter Study

Incidence of ventricular arrhythmias related to COVID infection and vaccination in patients with Brugada syndrome: Insights from a large Italian multicenter registry based on continuous rhythm monitoring

Michela Casella et al. J Cardiovasc Electrophysiol. 2023 Jun.

Abstract

Introduction: Brugada syndrome (BrS) has a dynamic ECG pattern that might be revealed by certain conditions such as fever. We evaluated the incidence and management of ventricular arrhythmias (VAs) related to COVID-19 infection and vaccination among BrS patients carriers of an implantable loop recorder (ILR) or implantable cardioverter-defibrillator (ICD) and followed by remote monitoring.

Methods: This was a multicenter retrospective study. Patients were carriers of devices with remote monitoring follow-up. We recorded VAs 6 months before COVID-19 infection or vaccination, during infection, at each vaccination, and up to 6-month post-COVID-19 or 1 month after the last vaccination. In ICD carriers, we documented any device intervention.

Results: We included 326 patients, 202 with an ICD and 124 with an ILR. One hundred and nine patients (33.4%) had COVID-19, 55% of whom developed fever. Hospitalization rate due to COVID-19 infection was 2.76%. After infection, we recorded only two ventricular tachycardias (VTs). After the first, second, and third vaccines, the incidence of non-sustained ventricular tachycardia (NSVT) was 1.5%, 2%, and 1%, respectively. The incidence of VT was 1% after the second dose. Six-month post-COVID-19 healing or 1 month after the last vaccine, we documented NSVT in 3.4%, VT in 0.5%, and ventricular fibrillation in 0.5% of patients. Overall, one patient received anti-tachycardia pacing and one a shock. ILR carriers had no VAs. No differences were found in VT before and after infection and before and after each vaccination.

Conclusions: From this large multicenter study conducted in BrS patients, followed by remote monitoring, the overall incidence of sustained VAs after COVID-19 infection and vaccination is relatively low.

Keywords: Brugada syndrome; COVID-19; fever; implantable cardioverter defibrillator; loop recorder; remote monitoring; vaccine.

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