COVID-19 HEART unveiling as atrial fibrillation: pathophysiology, management and future directions for research

Kanuri, Sri Harsha; Sirrkay, Prapthi Jayesh; Ulucay, Ayse Sena

doi:10.1186/s43044-023-00359-0

Cited by 6 publications

(3 citation statements)

References 129 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is difficult to ascertain whether COVID pneumonitis or LAAA triggered AF in our case, but long-haul COVID virus presence in myocardium after lung infection has been shown to provoke AF long after recovery from pneumonitis. 5 …”

Section: Discussionmentioning

confidence: 99%

Staged hybrid ablation in left atrial appendage aneurysm a rare cause of refractory atrial tachyarrhythmia—a case report

Mittal,

Navaratnarajah,

Harden

et al. 2024

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly, which can be congenital or acquired in origin. Because most cases are asymptomatic, it is typically diagnosed incidentally in the second to third decades of life. We present a case of a 28-year-old male with refractory atrial tachyarrhythmias and significantly reduced exercise tolerance. The informed consent was given by patient for this manuscript. Case summary We present a case of a 28-year-old male with refractory atrial tachyarrhythmias and significantly reduced exercise tolerance after an episode of COVID respiratory infection. He was referred by primary care physician for management of atrial fibrillation (AF) with CHA2DS2Vasc score zero. He had documented AF and atrial flutter (AFL) resistant to both chemical and electrical cardioversions. Initial portable focused transthoracic echocardiography documented borderline reduced left ventricular ejection fraction in context of AFL. Electrophysiological study confirmed the diagnosis of typical AFL. Successful radiofrequency ablation of cavo-tricuspid isthmus resulted in bidirectional isthmus conduction block. However, patient developed AF, which was electrically cardioverted at the end of procedure. Patient was discharged on bisoprolol, ramipril, and apixaban, and outpatient cardiac MRI was organized to look for post-COVID myocardial scarring. Patient had recurrence of symptoms, and this time it was due to AF. Multimodal imaging led to discovery of LAAA, in which after discussion in multidisciplinary meeting, he was accepted for and managed with surgical resection of LAAA with concomitant Cox-Maze IV procedure. On 9 months post-operative follow up, patient is maintaining sinus rhythm and has completely returned to baseline activities. Discussion A young patient with refractory atrial arrhythmia should be referred for multimodal cardiovascular imaging to rule out any structural heart disease. Left atrial appendage aneurysm is rare and can be managed conservatively, but surgical excision is most reported and appears to favour arrhythmia-free survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Staged hybrid ablation in left atrial appendage aneurysm a rare cause of refractory atrial tachyarrhythmia—a case report

Mittal,

Navaratnarajah,

Harden

et al. 2024

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

“…• AF is a common occurrence following infection with SARS-CoV-2 (COVID-19) [257][258][259][260][261][262][263][264][265][266][267]. • The Odds Ratio (OR) for AF 365 days after COVID-19 compared to a well-established control group was 1.83 in a large study [268].…”

Section: Examples In Which We Know That Infection Can Lead To Atrial ...mentioning

confidence: 99%

Fibrinaloid Microclots and Atrial Fibrillation

Kell,

Lip,

Pretorius

2024

Biomedicines

View full text Add to dashboard Cite

Atrial fibrillation (AF) is a comorbidity of a variety of other chronic, inflammatory diseases for which fibrinaloid microclots are a known accompaniment (and in some cases, a cause, with a mechanistic basis). Clots are, of course, a well-known consequence of atrial fibrillation. We here ask the question whether the fibrinaloid microclots seen in plasma or serum may in fact also be a cause of (or contributor to) the development of AF. We consider known ‘risk factors’ for AF, and in particular, exogenous stimuli such as infection and air pollution by particulates, both of which are known to cause AF. The external accompaniments of both bacterial (lipopolysaccharide and lipoteichoic acids) and viral (SARS-CoV-2 spike protein) infections are known to stimulate fibrinaloid microclots when added in vitro, and fibrinaloid microclots, as with other amyloid proteins, can be cytotoxic, both by inducing hypoxia/reperfusion and by other means. Strokes and thromboembolisms are also common consequences of AF. Consequently, taking a systems approach, we review the considerable evidence in detail, which leads us to suggest that it is likely that microclots may well have an aetiological role in the development of AF. This has significant mechanistic and therapeutic implications.

show abstract

“…З 13 хворих, у яких постійна ФП була до КІ, у 6 осіб (46,2 %) розвинулася тахіформа аритмії, в 1 (7,7 %) виникла брадіформа аритмії, у 6 (46,2 %) перебіг постійної ФП не змінився. Явна не- які мали асоційовані серцево-судинні фактори ризику [10,11]. Ретроспективний аналіз 78 725 пацієнтів із COVID-19 із супутніми захворюваннями в системі охорони здоров'я Массачусетсу Дженерал Бригам (англ.…”

Section: український журнал серцево-судинної хірургії том 31 № 3 2023unclassified

Features of the Course of Atrial Fibrillation in Patients with the History of COVID-19: Impact on the Possibility and Tactics of Restoring Sinus Rhythm

Stasyshena,

Sychov

2023

ujcvs

View full text Add to dashboard Cite

Introduction. Atrial fibrillation (AF) is a potentially life-threatening complication of infection. In general, AF has a high prevalence in elderly population with cardiovascular risk factors and comorbidities. Thus, the presence of AF correlates with adverse outcomes in patients with previous coronavirus disease (COVID-19) which deserves increased attention and should be appropriately treated to prevent adverse outcomes. The aim. To analyze the prevalence and clinical course of AF in hospitalized patients after COVID-19 to determine approaches to restoring sinus rhythm. Materials and methods. The study included 179 patients with various types of heart rhythm and conduction disorders who suffered from COVID-19 and were hospitalized to the Department of Clinical Arrhythmology and Electrophysiology of the National Scientific Center “The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the NAMS of Ukraine” from 09/20/2020 to 12/21/2021. 116 patients were hospitalized with AF who suffered from coronavirus infection between 1 and 12 months ago (5.1 ± 0.2 months on average). Other heart rhythm and conduction disorders were the cause of hospitalization for 63 patients (35.2%). The first group was formed by 36 people (31%) in whom AF occurred after coronavirus infection. The second group included 25 patients in whom the form of AF changed, namely: there was a transition from paroxysmal form of AF to persistent AF, or persistent AF to a permanent form of AF. The third group included 55 patients in whom the form of AF did not change. However, in the third group, two subgroups were formed: 3A consisting of 35 patients, in whom, although the form of AF did not change, the frequency or duration of paroxysms increased, and 3B, which included 20 patients without significant changes in the course of AF. As a control group, 49 patients with AF without a history of coronavirus infection were examined. Results. In most patients (65%), the reason for hospitalization was AF. The first recorded paroxysms of this arrhythmia were recorded in 31% of patients 2 months after the coronavirus infection. In this group, more than half of the cases (58.4%) were patients with persistent AF, and 8.3% of those hospitalized failed to restore sinus rhythm. In those who had AF before COVID-19, 75% of its course worsened: the frequency or duration of paroxysms increased. The persistent form of AF was dominant and occurred after a previous infection in 58% of cases. In patients who had AF before COVID-19, its course worsened (in 76% of the examined persons) after the infection. Patients with a history of coronavirus infection had more frequent use of drug therapy, which is probably due to the delayed time of hospitalization to the clinic from the onset of the paroxysm. Conclusion. AF is the most common arrhythmia and has a worse course in hospitalized patients after coronavirus infection.

show abstract

COVID-19 HEART unveiling as atrial fibrillation: pathophysiology, management and future directions for research

Cited by 6 publications

References 129 publications

Staged hybrid ablation in left atrial appendage aneurysm a rare cause of refractory atrial tachyarrhythmia—a case report

Staged hybrid ablation in left atrial appendage aneurysm a rare cause of refractory atrial tachyarrhythmia—a case report

Fibrinaloid Microclots and Atrial Fibrillation

Features of the Course of Atrial Fibrillation in Patients with the History of COVID-19: Impact on the Possibility and Tactics of Restoring Sinus Rhythm

Contact Info

Product

Resources

About