Atrial Fibrillation after COVID-19 Vaccination in an Adolescent: A Case Report

Several cases of cardiac arrhythmia after coronavirus disease 2019 (COVID-19) vaccination have been reported in adults. However, the Centers for Disease Control and Prevention do not list cardiac arrhythmias as a possible side effect of the COVID-19 vaccines. A previously healthy 18-year-old man presented at the Soonchunhyang University Bucheon Hospital with complaints of palpitations, acute chest tightness, and dyspnea. Two days before presentation, he had received the COVID-19 vaccine, BNT162b2 (Comirnaty, Pfizer-BioNTech; Pfizer, New York, NY, USA). His vital signs were stable; however, physical examination revealed irregular heartbeats without a cardiac murmur. A 12-lead electrocardiography showed atrial fibrillation. The patient received several medications for 6 months, without improvement. Eventually normal sinus rhythm was restored with cardioversion. The patient has remained asymptomatic for 1 year. We report the case of an adolescent with atrial fibrillation after receiving a messenger RNA COVID-19 vaccine. Atrial fibrillation should be considered a cardiovascular side effect of the COVID-19 vaccine in adolescents.