Arrhythmic Complications of Patients Hospitalized With COVID-19

Peltzer, Bradley; Manocha, Kevin K.; Ying, Xiaohan; Kirzner, Jared; Ip, James E.; Thomas, George; Liu, Christopher F.; Markowitz, Steven M.; Lerman, Bruce B.; Safford, Monika M.; Goyal, Parag; Cheung, Jim W.

doi:10.1161/circep.120.009121

Cited by 35 publications

(57 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently, less RF application time was noted in repeat ablation. This is in line with more recent data on repeat ablations from the CIRCA-DOSE trial [ 21 ]. Compared to other studies with similar comparisons, recurrence rates were higher in our study and generally in line with data from CIRCA-DOSE [ 3 ].…”

Section: Discussionsupporting

confidence: 91%

Safety and patient-reported outcomes in index ablation versus repeat ablation in atrial fibrillation: insights from the German Ablation Registry

et al. 2020

View full text Add to dashboard Cite

Background Pulmonary vein isolation is an established strategy for catheter ablation of atrial fibrillation (AF). However, in a significant number of patients, a repeat procedure is mandatory due to arrhythmia recurrence. In this study, we report safety data and procedural details of patients undergoing index ablation versus repeat ablation in a registry-based real-life setting. Methods Patients from the German Ablation Registry, a prospective, multicentre registry of patients undergoing ablation between January 2007 and January 2010 were included. Results A total of 4155 patients were enrolled in the study. Group I (index ablation) consisted of 3377/4155 (82.1%) and group II (repeat ablation) of 738/4155 (17.9%). Patients in group I had a significantly higher ratio of paroxysmal AF (69.3% vs 61.9%, p < 0.001) and significantly less persistent AF (30.7% vs 38.1%, p < 0.001). The repeat group showed significantly lower mean RF application duration (2580 s. vs 1960, p < 0.001), less fluoroscopy time (29 min. vs. 27 min., p < 0.001), less mean dose area product (DAP) (3744 cGy × cm2 vs 3325 cGy × cm2, p = 0.001), and shorter study duration (181.2 min. vs 163.6 min., p < 0.001). No statistical difference between the groups was found in terms of mortality (0.3% vs 0.1%, p = 0.39), MACE (0.4% vs 0.3%, p = 0.58), MACCE (0.8% vs 0.6%, p = 0.47), composite safety endpoint (1.5% vs 1.4%, p = 0.76), and arrhythmia recurrence (43.8% vs 41.9%, p = 0.37) during 1-year follow-up. Both groups reported to have improved or no symptoms (80.4% vs 77.8%, p = 0.13). Conclusion Repeat catheter ablation is safe and provides a symptomatic relief comparable to index ablation. Repeat procedures are significantly shorter and use less fluoroscopy.

show abstract

Section: Discussionsupporting

confidence: 91%

Safety and patient-reported outcomes in index ablation versus repeat ablation in atrial fibrillation: insights from the German Ablation Registry

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A case series of COVID-19 patients with ST-segment elevation on ECG portended a poor prognosis ( 12 ). Arrhythmias are reported in 25% of COVID-19 patients, with AF/atrial flutter being the most common ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Prone and Supine 12-Lead ECG Comparisons

Chieng

Sugumar

Kaye

et al. 2021

JACC: Clinical Electrophysiology

View full text Add to dashboard Cite

Objectives This study sought to describe expected changes in a mirror-image prone electrocardiogram (ECG) compared with normal supine, including a range of cardiac conditions. Background Unwell COVID-19 patients are at risk of cardiac complications. Prone ventilation is recommended but poses practical challenges to acquisition of a 12-lead ECG. The effects of prone positioning on the ECG remain unknown. Methods 100 patients each underwent 3 ECGs: standard supine front (SF); prone position with precordial leads attached to front (PF); and prone with precordial leads attached to back in a mirror image to front (PB). Results Prone positioning was associated with QTc prolongation (PF 437 ± 32 ms vs. SF 432 ± 31 ms; p < 0.01; PB 436 ± 34 ms vs. SF 432 ± 31 ms; p = 0.02). In leads V 1 to V 3 on PB ECG, a qR morphology was present in 90% and changes in T-wave polarity in 84%. In patients with anterior ischemia, ST-segment changes in V 1 to V 3 on supine ECG were no longer visible on PB in 100% and replaced by an R wave in V 1 . Bundle branch block (BBB) remained detectable in 100% on PB, with left BBB appearing as right BBB on PB in 71% and QRS narrowing with qR in V 1 for right BBB. ST-segment/T-wave changes in limb leads and arrhythmia detection were largely unaffected in PB. Conclusions As expected, the PB ECG is unreliable for the detection of anterior myocardial injury but remains useful for ST-segment/T-wave abnormalities in limb leads, BBB detection, and rhythm monitoring. The prone ECG is a useful screening tool with diagnostic utility in COVID-19 patients who require prone ventilation.

show abstract

“…Different types of arrythmias have been associated with COVID-19 including atrial fibrillation, atrioventricular blocks, polymorphic ventricular tachycardia, and pulseless electric activity, not always correlating with the severity of lung injury [66]. Supraventricular tachycardias (atrial fibrillation/atrial flutter) are among the most commonly described heart rhythm disturbances with an estimated prevalence of 15.8% (166/1053) as reported by Peltzer et al [67]. Of note, in this study, 101 out of 166 (60.8%) patients had no prior history of atrial fibrillation or atrial flutter.…”

Section: Arrhythmiasmentioning

confidence: 97%

Cardiac complications during the active phase of COVID-19: review of the current evidence

et al. 2021

View full text Add to dashboard Cite

Growing reports since the beginning of the pandemic and till date describe increased rates of cardiac complications (CC) in the active phase of coronavirus disease 2019 (COVID-19). CC commonly observed include myocarditis/myocardial injury, arrhythmias and heart failure, with an incidence reaching about a quarter of hospitalized patients in some reports. The increased incidence of CC raise questions about the possible heightened susceptibility of patients with cardiac disease to develop severe COVID-19, and whether the virus itself is involved in the pathogenesis of CC. The wide array of CC seems to stem from multiple mechanisms, including the ability of the virus to directly enter cardiomyocytes, and to indirectly damage the heart through systemic hyperinflammatory and hypercoagulable states, endothelial injury of the coronary arteries and hypoxemia. The induced CC seem to dramatically impact the prognosis of COVID-19, with some studies suggesting over 50% mortality rates with myocardial damage, up from ~ 5% overall mortality of COVID-19 alone. Thus, it is particularly important to investigate the relation between COVID-19 and heart disease, given the major effect on morbidity and mortality, aiming at early detection and improving patient care and outcomes. In this article, we review the growing body of published data on the topic to provide the reader with a comprehensive and robust description of the available evidence and its implication for clinical practice.

show abstract

Arrhythmic Complications of Patients Hospitalized With COVID-19

Cited by 35 publications

References 3 publications

Safety and patient-reported outcomes in index ablation versus repeat ablation in atrial fibrillation: insights from the German Ablation Registry

Safety and patient-reported outcomes in index ablation versus repeat ablation in atrial fibrillation: insights from the German Ablation Registry

Prone and Supine 12-Lead ECG Comparisons

Cardiac complications during the active phase of COVID-19: review of the current evidence

Contact Info

Product

Resources

About