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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue3
Subject Area: Medicine
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DOI: 10.5272/jimab.2026323.7081
Published online: 14 September 2026
Review article
J of IMAB. 2026 Jul-Sep;32(3):7081-7087
RHYTHM AND CONDUCTION DISORDERS IN COVID-19: FROM MYOCARDIAL INJURY TO CLINICAL ARRHYTHMIAS
Zhivko Yovchev
, Emil Popov, Konstantin Gospodinov,
Department of Cardiology, Pulmonology and Endocrinology, Medical University – Pleven, Bulgaria.
ABSTRACT:
COVID-19 is associated with a broad spectrum of rhythm and conduction disorders, particularly among hospitalized and critically ill patients. Arrhythmogenesis is multifactorial and reflects systemic inflammation, hypoxaemia, myocardial ischaemia or injury, myocarditis, autonomic imbalance, thromboembolic disease, electrolyte disturbances and drug-related proarrhythmia. Atrial fibrillation is the most frequently reported sustained arrhythmia, while ventricular tachyarrhythmias, bradyarrhythmias and atrioventricular conduction disturbances occur predominantly in patients with severe disease or myocardial injury. Contemporary population-based evidence also indicates that arrhythmic risk may persist beyond the acute infection, although the absolute risk and the contribution of direct viral myocardial injury remain incompletely defined. This review summarizes the principal mechanisms, clinical phenotypes and management considerations of COVID-19-related arrhythmias and highlights emerging evidence concerning post-acute autonomic dysfunction and long-term rhythm complications.
Keywords: arrhythmias, atrial fibrillation, COVID-19, myocardial injury, conduction disorders,
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Please cite this article as: Yovchev Z, Popov E, Gospodinov K. Rhythm and Conduction Disorders in COVID-19: From Myocardial Injury to Clinical Arrhythmias. J of IMAB. 2026 Jul-Sep;32(3):7081-7087. [Crossref - 10.5272/jimab.2026323.7081]
Correspondence to: Zhivko Yovchev, MD, Clinic of Cardiology, UMHAT “Dr. Georgi Stranski”, Pleven; 8A, Georgi Kochev Str. Pleven, Bulgaria. E-mail: dryovchev@mail.com
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Received: 04 March 2026
Published online: 14 September 2026