"Abstract
... We report a case series of patients affected by cardiac arrhythmias post-mRNA vaccine from our clinical practice and the literature. Reviewing the official vigilance database, we found that heart rhythm disorders after COVID vaccination are not uncommon and deserve more clinical and scientific attention. Since the COVID vaccine is the only vaccination related to this side effect, questions arose about whether these vaccines could affect heart conduction. Although the risk–benefit ratio is clearly in favor of vaccination, heart rhythm disorders are not a negligible issue, and there are red flags in the literature about the risk of post-vaccination malignant arrhythmias in some predisposed patients. In light of these findings, we reviewed the potential molecular pathways for the COVID vaccine to impact cardiac electrophysiology and cause heart rhythm disorders...
4. Conclusions
We treated several patients at our clinical practice complaining of palpitations or worsening of palpitations after an mRNA COVID vaccination. Concordantly, data from the vigilance database and the literature report cases of heart rhythm disorders in the post-mRNA vaccination period and malignant arrhythmias in predisposed patients, suggesting a potential impact on the cardiac conduction system. Otherwise, we have not encountered heart rhythm disorders after administering other vaccines and found no signs of arrhythmias in the vigilance databases. Since cardiac arrhythmias have high morbidity and mortality, and considering the red flags in the literature describing the risk of malignant arrhythmias in patients with genetic arrhythmic predisposition, the topic must be further investigated.
We analyzed the molecular pathways of new mRNA vaccines and found they may potentially provoke electric disturbances, specifically regarding their effects on the ACE system and the role of the spike protein in the contest of cardiovascular complication. In addition, these observations raise concerns regarding the central role of the ACE system on heart conduction homeostasis and possible detrimental impact of iatrogenic interference with this system in this context."
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