Atrial fibrillation burden during the coronavirus disease 2019 pandemic

Europace - Tập 23 Số 9 - Trang 1493-1501 - 2021
Catherine O’Shea1,2, Melissa E. Middeldorp1,2, Gijo Thomas1, Curtis Harper3, Adrian D. Elliott1, Noemi Ray3, Kevin R. Campbell1,3, Dennis H. Lau1,2, Prashanthan Sanders1,2
1Centre for Heart Rhythm Disorders, University of Adelaide, North Terrace, Adelaide, South Australia, 5000, Australia
2Department of Cardiology, Port Road, Adelaide, South Australia, 5000, Australia
3Pacemate, Bradenton, FL, USA

Tóm tắt

Abstract Aims The aim of this study is to determine the association between the coronavirus disease 2019 (COVID-19) pandemic and atrial fibrillation (AF) occurrence in individuals with cardiac implantable electronic devices (CIEDs). Method and results Multi-centre, observational, cohort study over a 100-day period during the COVID-19 pandemic (COVID-19) in the USA. Remote monitoring was used to assess AF episodes in patients with a CIED (pacemaker or defibrillator; 20 centres, 13 states). For comparison, the identical 100-day period in 2019 was used (Control). The primary outcomes were the AF burden during the COVID-19 pandemic, and the association of the pandemic with AF occurrence, as compared with 1 year prior. The secondary outcome was the association of AF occurrence with per-state COVID-19 prevalence. During COVID-19, 10 346 CIEDs with an atrial lead were monitored. There were 16 570 AF episodes of ≥6 min transmitted (16 events per 1000 patient days) with a significant increase in proportion of patients with AF episodes in high COVID-19 prevalence states compared with low prevalence states [odds ratio 1.34, 95% confidence interval (CI) 1.21–1.48, P < 0.001]. There were significantly more AF episodes during COVID-19 compared with Control [incident rate ratio (IRR) 1.33, 95% CI 1.25–1.40, P < 0.001]. This relationship persisted for AF episodes ≥1 h (IRR 1.65, 95% CI 1.53–1.79, P < 0.001) and ≥6 h (IRR 1.54, 95% CI 1.38–1.73, P < 0.001). Conclusion During the first 100 days of COVID-19, a 33% increase in AF episodes occurred with a 34% increase in the proportion of patients with AF episodes observed in states with higher COVID-19 prevalence. These findings suggest a possible association between pandemic-associated social disruptions and AF in patients with CIEDs. Clinical TRIAL registration Australian New Zealand Clinical Trial Registry: ACTRN12620000692932.

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Tài liệu tham khảo

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Europace

Tập 23 Số 9

1493-1501

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