Sinus Arrest Associated With a COVID-19 Nasopharyngeal Swab Procedure: A Case Report

During the COVID-19 pandemic, nasal swabs became a routine test for infection. This non-invasive procedure is typically regarded as benign and rarely associated with complications. However, physical stimulation of the nasopharynx and trigeminal nerve can trigger the trigeminocardiac reflex (TCR), a vagally mediated cardioinhibitory response that can lead to sinus arrest. In this study, a clinical trial participant experienced a 3.4 s episode of sinus arrest which was captured on electrocardiogram telemetry during a routine COVID-19 nasal swab test. Diagnosis of the TCR was based upon the plausibility and reversibility criteria, which are hallmarks of this condition. Healthcare providers need to be aware of this phenomenon as well as other potential complications when performing nasopharyngeal swabs.