Post-COVID Arrhythmia Risk Model (Autonomic + ECG) Calculator

Age (years)

Sex

Weeks since confirmed COVID-19

Resting Heart Rate (bpm)

SDNN (ms, 24-hour or standard 5-min)

RMSSD (ms)

QTc (ms)

PVC Burden (% of beats in 24-h Holter)

Orthostatic Tachycardia / POTS (ΔHR ≥30 bpm within 10 min standing)

Syncope / Near-syncope since COVID-19

Known Structural Heart Disease (LV dysfunction, scar, valve disease)

Post-COVID Arrhythmia Risk Model (Autonomic + ECG): Explanation and Clinical Context
This model integrates autonomic markers (HRV indices) and ECG variables to estimate post-acute arrhythmic risk in individuals recovering from COVID-19. Reduced HRV (low SDNN, RMSSD) reflects sympathetic predominance and vagal withdrawal, patterns observed in post-COVID dysautonomia. QTc prolongation captures impaired repolarization reserve and drug- or inflammation-related ion channel effects. PVC burden quantifies arrhythmic substrate and cardiomyopathy risk. Clinical features such as POTS, syncope, and pre-existing structural heart disease further increase arrhythmic vulnerability.

Model Status
This calculator is an evidence-informed clinical aid, not a validated risk score. It synthesizes findings from recent post-COVID arrhythmia literature to support structured assessment and monitoring decisions.

References:
Huseynov A, et al. Cardiac Arrhythmias in Post-COVID Syndrome: Prevalence and Pathology. 2023.
American Heart Association Scientific Statement: Cardiac Arrhythmias and Autonomic Dysfunction With/After COVID-19. 2024.
Menezes-Junior AS, et al. Cardiac Autonomic Function in Long COVID-19. 2022.
Task Force of the ESC/NASPE. Heart-rate variability standards (SDNN/RMSSD definitions and use). 1996.
Baman TS, et al. PVC burden and cardiomyopathy thresholds. 2010.
Khatib R, et al. Managing drug-induced QT prolongation. 2020.

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