{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:08:46Z","timestamp":1793758126784,"version":"4.6.1"},"reference-count":55,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Facultad de Ciencias M\u00e9dicas","award":["2-03-01-01"],"award-info":[{"award-number":["2-03-01-01"]}]},{"DOI":"10.13039\/501100017261","name":"Universidad Nacional Autonoma de Honduras","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100017261","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/03xyve152","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Cardiac involvement in dengue has been increasingly recognized, yet the true burden and spectrum of arrhythmias remain uncertain due to heterogeneous and fragmented evidence. We conducted a systematic review and meta-analysis to estimate the proportion of cardiac arrhythmias in patients with dengue and to describe the distribution of major arrhythmia subtypes. Methods: We searched PubMed\/MEDLINE, EMBASE, LILACS, Global Index Medicus, and Google Scholar from inception to November 2025 without language restrictions. Observational studies reporting the number of dengue patients evaluated for arrhythmias and the number with at least one rhythm disturbance were included. Random-effects generalized linear mixed models with a logit transformation were used to estimate pooled proportion with 95% confidence intervals (CIs). Subgroup analyses were performed by age group. Risk of bias was assessed using the Joanna Briggs Institute tool, and certainty of evidence was evaluated with GRADE. Results: Thirty-five studies, including 6948 patients, were analyzed. The pooled proportion of any arrhythmia was 24.48% (95% CI 17.54\u201333.07), with a higher proportion in adults (30.00%) than in children (10.73%). Sinus bradycardia (11.84%) and sinus tachycardia (10.63%) were the most frequent abnormalities. Atrioventricular block was uncommon (1.33%). Between-study heterogeneity was high for most outcomes. No significant small-study effects were detected. Conclusions: Cardiac arrhythmias occur in approximately one in four patients with dengue, predominantly as sinus rate abnormalities. While often transient, these findings support the role of baseline and risk-based ECG monitoring, particularly in hospitalized adults and patients with severe disease.<\/jats:p>","DOI":"10.3390\/pathogens15050497","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T13:23:37Z","timestamp":1777987417000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Arrhythmias in Dengue: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-6314","authenticated-orcid":false,"given":"Dar\u00edo S.","family":"L\u00f3pez-Delgado","sequence":"first","affiliation":[{"name":"Hospital Universitario Departamental de Nari\u00f1o, Pasto 520002, Colombia"},{"name":"Facultad de Medicina, Universidad Cooperativa de Colombia, Pasto 520002, Colombia"},{"name":"Facultad de Medicina, Universidad San Martin, Pasto 520002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1565-5269","authenticated-orcid":false,"given":"Mathias S.","family":"Renteros-Ramirez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0638-9243","authenticated-orcid":false,"given":"Joshua Emmanuel","family":"Arteaga-Bola\u00f1os","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Cooperativa de Colombia, Pasto 520002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold E.","family":"V\u00e1squez-Ucros","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Cooperativa de Colombia, Pasto 520002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-8423","authenticated-orcid":false,"given":"Kevin Alexander","family":"Burbano-Castro","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Cooperativa de Colombia, Pasto 520002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0930-3701","authenticated-orcid":false,"given":"Valentina","family":"Reina-Melo","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad San Martin, Pasto 520002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Niebles-Blanco","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Cooperativa de Colombia, Pasto 520002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Calzada-Gonzales","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional Hermilio Valdizan, Hu\u00e1nuco 10004, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9002-5807","authenticated-orcid":false,"given":"Lysien I.","family":"Zambrano","sequence":"additional","affiliation":[{"name":"Department of Morphological Sciences, School of Medical Sciences, Universidad Nacional Aut\u00f3noma de Honduras, Tegucigalpa 11101, Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-8887","authenticated-orcid":false,"given":"Valmore","family":"Bermudez","sequence":"additional","affiliation":[{"name":"Centro de Investigaciones en Ciencias de la Vida, Facultad de Ciencias de la Salud, Universidad Sim\u00f3n Bol\u00edvar, Barranquilla 080002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9773-2192","authenticated-orcid":false,"given":"Alfonso J.","family":"Rodriguez-Morales","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad Cientifica del Sur, Lima 15074, Peru"},{"name":"Grupo de Investigaci\u00f3n Biomedicina, Faculty of Medicine, Fundaci\u00f3n Universitaria Aut\u00f3noma de las Am\u00e9ricas-Instituci\u00f3n Universitaria Visi\u00f3n de las Am\u00e9ricas, Risaralda 660003, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105710","DOI":"10.1016\/j.meegid.2024.105710","article-title":"Dengue virus: Etiology, epidemiology, pathobiology, and developments in diagnosis and control\u2014A comprehensive review","volume":"127","author":"Pourzangiabadi","year":"2025","journal-title":"Infect. 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