Management of atrial fibrillation in the emergency room and in the cardiology ward: the BLITZ AF study

Gulizia, Michele Massimo; Cemin, Roberto; Colivicchi, Furio; Luca, Leonardo De; Lenarda, Andrea Di; Boriani, Giuseppe; Pasquale, Giuseppe Di; Nardi, Federico; Scherillo, Marino; Lucci, Donata; Fabbri, Gianna; Maggioni, Aldo P.; Investigators, Blitz-Af

doi:10.1093/europace/euy166

Cited by 31 publications

(11 citation statements)

References 18 publications

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“…Further, the percentage of the patients who attended the ED with a primary diagnosis of AF was approximately 1% during both periods. This finding is consistent with the reported incidence of primary AF diagnosis in a large observational study [ 6 ], and it supports the accuracy of the obtained results but illustrates the difficulty of a study of this matter as a single-site study.…”

Section: Discussionsupporting

confidence: 92%

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The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department

Bilaszewski

Timler

Budrewicz

et al. 2021

IJERPH

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Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. Materials and Methods: A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July–December 2019 (pre-pandemic period) versus July–December 2020 (pandemic period) was performed. Results: During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/−13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5–30 h) during the pandemic period vs. 5 h (3–24 h) during the non-pandemic period (p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital (p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. Conclusions: 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode.

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Section: Discussionsupporting

confidence: 92%

“…The rate of hospital admissions for patients with a primary diagnosis of AF was 27.8% in the Blitz-AF study. This rate exceeded the overall hospital admission rate observed among all patients who presented to the ED for treatment [ 6 ].…”

Section: Introductionmentioning

confidence: 90%

The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department

Bilaszewski

Timler

Budrewicz

et al. 2021

IJERPH

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“…AF is a very common arrhythmia and its acute management carries a high burden of workload to EDs and Cardiology Clinics [ 32 ]. In view of its epidemiological profile, AF affects subjects in the range of age at highest risk of adverse outcomes if infected by Sars-Cov-2 [ 33 ] and the caution in avoiding admissions to hospital may explain the important reduction in acute pharmacological and non-pharmacological treatments applied for AF in emergency setting reported during the study period, as reported in this survey.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Boriani

Palmisano²,

Guerra

et al. 2020

Intern Emerg Med

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COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March-April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy.

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“…Although the clinical profile and outcome of patients with first-diagnosed AF in AF registries were less favourable than those with paroxysmal AF, rather resembling permanent AF, 1055,1056 OAC prescription rates were the lowest in patients with first-diagnosed AF. 1057 In patients with first-diagnosed AF, the ABC pathway should resemble all steps outlined in the Central Illustration. 11.3 Acute coronary syndromes, percutaneous coronary intervention, and chronic coronary syndromes in patients with atrial fibrillation…”

Section: Bmentioning

confidence: 99%

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

Hindricks¹,

Potpara²,

Dagres³

et al. 2021

Revista Española de Cardiología (English Edition)

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277

637

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Management of atrial fibrillation in the emergency room and in the cardiology ward: the BLITZ AF study

Abstract: Atrial fibrillation still represents a significant burden on health care system. Oral anticoagulant use increased over time even if compliance with guidelines, with respect to prevention of the risk of stroke, remains suboptimal.

Cited by 31 publications

References 18 publications

The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department

The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

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