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Worldwide Survey of COVID-19-Associated Arrhythmias

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Author(s)
Ellie J. CoromilasStephanie KochavIsaac GoldenthalAngelo BivianoHasan GaranSeth GoldbargJoon-Hyuk KimIlhwan YeoCynthia TracyShant AyanianJoseph AkarAvinainder SinghShashank JainLeandro ZimermanMaurício PimentelStefan OsswaldRaphael TwerenboldNicolas SchaerliLia CrottiDaniele FabbriGianfranco ParatiYi LiFelipe AtienzaEduardo ZatarainGary TseKeith Sai Kit LeungMilton E. Guevara-ValdiviaCarlos A. Rivera-SantiagoKyoko SoejimaPaolo De FilippoPaola FerrariGiovanni MalanchiniPrapa KanagaratnamSaud KhawajaGhada W. MikhailMauricio ScanavaccaLudhmila Abrahão HajjarBrenno RizerioLuciana SacilottoReza MollazadehMasoud EslamiVahideh Laleh farAnna Vittoria MattioliGiuseppe BorianiFederico MiglioreAlberto CiprianiFilippo DonatoPaolo CompagnucciMichela CasellaAntonio Dello RussoJames CoromilasAndrew AboymeConnor Galen O'BrienFatima RodriguezPaul J. WangAditi NaniwadekarMelissa MoeyChia Siang KowWee Kooi CheahAngelo AuricchioGiulio ConteJongmin HwangSeongwook HanPietro Enea LazzeriniFederico FranchiAmato SantoroPier Leopoldo CapecchiJose A. JoglarAnna G. RosenblattMarco ZardiniSerena BricoliRosario BonuraJulio Echarte-MoralesTomás Benito-GonzálezCarlos Minguito-CarazoFelipe Fernández-VázquezElaine Y. Wan
Keimyung Author(s)
Hwang, Jong MinHan, Seong Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circ Arrhythm Electrophysiol
Issued Date
2021
Volume
14
Issue
3
Keyword
arrhythmiaatrial fibrillationtachycardiatorsade de pointesbradycardiaCOVID-19atrial flutter
Abstract
Background:
Coronavirus disease 2019 (COVID-19) has led to over 1 million deaths worldwide and has been associated with cardiac complications including cardiac arrhythmias. The incidence and pathophysiology of these manifestations remain elusive. In this worldwide survey of patients hospitalized with COVID-19 who developed cardiac arrhythmias, we describe clinical characteristics associated with various arrhythmias, as well as global differences in modulations of routine electrophysiology practice during the pandemic.

Methods:
We conducted a retrospective analysis of patients hospitalized with COVID-19 infection worldwide with and without incident cardiac arrhythmias. Patients with documented atrial fibrillation, atrial flutter, supraventricular tachycardia, nonsustained or sustained ventricular tachycardia, ventricular fibrillation, atrioventricular block, or marked sinus bradycardia (heart rate<40 bpm) were classified as having arrhythmia. Deidentified data was provided by each institution and analyzed.

Results:
Data were collected for 4526 patients across 4 continents and 12 countries, 827 of whom had an arrhythmia. Cardiac comorbidities were common in patients with arrhythmia: 69% had hypertension, 42% diabetes, 30% had heart failure, and 24% had coronary artery disease. Most had no prior history of arrhythmia. Of those who did develop an arrhythmia, the majority (81.8%) developed atrial arrhythmias, 20.7% developed ventricular arrhythmias, and 22.6% had bradyarrhythmia. Regional differences suggested a lower incidence of atrial fibrillation in Asia compared with other continents (34% versus 63%). Most patients in North America and Europe received hydroxychloroquine, although the frequency of hydroxychloroquine therapy was constant across arrhythmia types. Forty-three percent of patients who developed arrhythmia were mechanically ventilated and 51% survived to hospital discharge. Many institutions reported drastic decreases in electrophysiology procedures performed.

Conclusions:
Cardiac arrhythmias are common and associated with high morbidity and mortality among patients hospitalized with COVID-19 infection. There were significant regional variations in the types of arrhythmias and treatment approaches.
Keimyung Author(s)(Kor)
황종민
한성욱
Publisher
School of Medicine (의과대학)
Citation
Ellie J. Coromilas et al. (2021). Worldwide Survey of COVID-19-Associated Arrhythmias. Circ Arrhythm Electrophysiol, 14(3), e009458. doi: 10.1161/CIRCEP.120.009458
Type
Article
ISSN
1941-3084
Source
https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009458
DOI
10.1161/CIRCEP.120.009458
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43589
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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