Alam Md Mashiul, Paul Timir, Aggarwal Abhinav, Zarich Stuart
Internal Medicine, Bridgeport Hospital/Yale University Program, Bridgeport, CT, USA.
University of Tennessee Health Sciences Center, Saint Thomas Heart Institute, Nashville, TN, USA.
Am J Med Sci. 2024 Apr;367(4):235-242. doi: 10.1016/j.amjms.2024.01.004. Epub 2024 Jan 5.
Influenza infection is rarely associated with cardiac conduction disorder. Cardiac arrhythmias due to such an infection have a full spectrum with ventricular arrythmias being the most common.
In our systematic review from PubMed, OVID Medline and EMBASE we have identified 23 articles describing arrythmias associated with different influenza infection. Most of them were case reports where ventricular arrhythmias were the most common.
Complete heart block after influenza infection is usually temporary and a permanent pacemaker is rarely needed. There are reports of Influenza associated with arrhythmias in adults, neonates, and even fetuses in pregnant woman. Different mechanisms were described in literatures by which influenza causes arrhythmias such as interleukin 6 & tumor necrosis factor-alpha mediated inflammatory response, sympathetic overactivation, focal myocarditis and cleavage of angiotensin converting enzyme 2 protein which is cardioprotective.
ACE 2 binder influenza viruses have more prone to be associated with cardiac conduction disorder. Oseltamivir for influenza infection is also associated with bradycardia and can shorten or lengthen QT segment. Influenza vaccination has found to be protective from cardiac arrhythmia.
流感感染很少与心脏传导障碍相关。此类感染所致的心律失常范围广泛，室性心律失常最为常见。
在我们对PubMed、OVID Medline和EMBASE进行的系统评价中，我们确定了23篇描述与不同流感感染相关的心律失常的文章。其中大多数是病例报告，室性心律失常最为常见。
流感感染后的完全性心脏传导阻滞通常是暂时的，很少需要永久起搏器。有关于成人、新生儿甚至孕妇胎儿流感与心律失常相关的报道。文献中描述了流感导致心律失常的不同机制，如白细胞介素6和肿瘤坏死因子-α介导的炎症反应、交感神经过度激活、局灶性心肌炎以及具有心脏保护作用的血管紧张素转换酶2蛋白的裂解。
与血管紧张素转换酶2结合的流感病毒更容易与心脏传导障碍相关。用于流感感染的奥司他韦也与心动过缓有关，并且可使QT间期缩短或延长。已发现流感疫苗对心律失常有预防作用。
