# Infection with COVID-19 Complicated by Sinus Arrest

## TL;DR

This case study shows that a second infection with COVID-19 can cause a reversible heart rhythm problem called sinus arrest in an elderly patient.

## Contribution

The study highlights the reversible cardiac arrhythmia caused by reinfection with COVID-19, suggesting pacemaker implantation may not always be necessary.

## Key findings

- A 79-year-old woman developed sinus arrest after her second bout of COVID-19.
- The longest asystole recorded was 7.2 seconds, but the condition resolved without permanent pacemaker implantation.
- The case suggests that arrhythmias caused by COVID-19 may be reversible.

## Abstract

As a respiratory tract-transmitted disease, coronavirus disease 2019 (COVID-19) exerts a profound immune injury effect, leading not only to pulmonary impairment but also to cardiac complications. We present a case of a 79-year-old woman, who had previously contracted COVID-19 and subsequently developed sinus arrest (SA) following her second infection. The longest asystole time detected by Holter monitoring was 7.2 seconds. Although the patient met criteria for permanent pacemaker implantation, her family declined this intervention and conservative management was pursued instead. However, after a period of observation, the patient's SA resolved. The present case study describes a patient who experienced SA upon reinfection with COVID-19, which was not present during the initial infection. It emphasizes the impact of COVID-19 on cardiac health, particularly its potential to induce arrhythmias. In addition, it is worth noting that the arrhythmia induced by a COVID-19 infection may show reversibility, suggesting that a permanent pacemaker might not be the priority option if further pacing therapy is being considered.