Khan Muhammad H, Aqtash Obadah, Harris David M, Costea Alexandru I, Gerson Myron C
Department of Internal Medicine, University of Cincinnati, USA.
Department of Cardiovascular Medicine, University of Cincinnati, USA.
Case Rep Cardiol. 2022 Aug 18;2022:1157728. doi: 10.1155/2022/1157728. eCollection 2022.
Ventricular tachycardia (VT) or ventricular fibrillation (VF) storm associated with severe acute respiratory syndrome coronavirus 2 infection is a potentially fatal complication; the correlation of these 2 disorders, however, has not been well studied. This retrospective case series examined outcomes of 2 patients who were admitted for repeated implantable cardioverter-defibrillator shocks with or without syncope and observed to have VT/VF storms with COVID-19. Mechanisms of VT/VF storms in COVID-19 are multifactorial including myocarditis, systemic inflammation, hyperadrenergic state, hemodynamic instability, hypoxia, acidosis, and proarrhythmic drugs. A higher incidence of VT/VF storm is observed in patients with comorbidities and those requiring critical care, with some studies reporting increased mortality. In our cohort, 1 of the 2 patients succumbed to the complications from COVID-19, and the other patient was discharged to home in stable condition. Monitoring of life-threatening arrhythmias in the setting of COVID-19 may need to be adopted to prevent morbidity and mortality.
与严重急性呼吸综合征冠状病毒2感染相关的室性心动过速（VT）或室颤（VF）风暴是一种潜在的致命并发症；然而，这两种病症之间的相关性尚未得到充分研究。本回顾性病例系列研究了2例因反复接受植入式心律转复除颤器电击（伴或不伴晕厥）入院且被观察到患有COVID-19相关VT/VF风暴的患者的结局。COVID-19中VT/VF风暴的机制是多因素的，包括心肌炎、全身炎症、高肾上腺素能状态、血流动力学不稳定、缺氧、酸中毒和促心律失常药物。在合并症患者和需要重症监护的患者中观察到VT/VF风暴的发生率更高，一些研究报告死亡率增加。在我们的队列中，2例患者中有1例死于COVID-19并发症，另1例患者病情稳定后出院回家。在COVID-19背景下，可能需要对危及生命的心律失常进行监测，以预防发病和死亡。
