Worldwide Survey of COVID-19-Associated Arrhythmias

TY - JOUR

T1 - Worldwide Survey of COVID-19-Associated Arrhythmias

AU - Coromilas, Ellie J

AU - Kochav, Stephanie

AU - Goldenthal, Isaac

AU - Biviano, Angelo

AU - Garan, Hasan

AU - Goldbarg, Seth

AU - Kim, Joon-Hyuk

AU - Yeo, Ilhwan

AU - Tracy, Cynthia

AU - Ayanian, Shant

AU - Akar, Joseph

AU - Singh, Avinainder

AU - Jain, Shashank

AU - Zimerman, Leandro

AU - Pimentel, Maurício

AU - Osswald, Stefan

AU - Twerenbold, Raphael

AU - Schaerli, Nicolas

AU - Crotti, Lia

AU - Fabbri, Daniele

AU - Parati, Gianfranco

AU - Li, Yi

AU - Atienza, Felipe

AU - Zatarain, Eduardo

AU - Tse, Gary

AU - Leung, Keith Sai Kit

AU - Guevara-Valdivia, Milton E

AU - Rivera-Santiago, Carlos A

AU - Soejima, Kyoko

AU - De Filippo, Paolo

AU - Ferrari, Paola

AU - Malanchini, Giovanni

AU - Kanagaratnam, Prapa

AU - Khawaja, Saud

AU - Mikhail, Ghada W

AU - Scanavacca, Mauricio

AU - Abrahão Hajjar, Ludhmila

AU - Rizerio, Brenno

AU - Sacilotto, Luciana

AU - Mollazadeh, Reza

AU - Eslami, Masoud

AU - Laleh Far, Vahideh

AU - Mattioli, Anna Vittoria

AU - Boriani, Giuseppe

AU - Migliore, Federico

AU - Cipriani, Alberto

AU - Donato, Filippo

AU - Compagnucci, Paolo

AU - Casella, Michela

AU - Dello Russo, Antonio

AU - Coromilas, James

AU - Aboyme, Andrew

AU - O'Brien, Connor Galen

AU - Rodriguez, Fatima

AU - Wang, Paul J

AU - Naniwadekar, Aditi

AU - Moey, Melissa

AU - Kow, Chia Siang

AU - Cheah, Wee Kooi

AU - Auricchio, Angelo

AU - Conte, Giulio

AU - Hwang, Jongmin

AU - Han, Seongwook

AU - Lazzerini, Pietro Enea

AU - Franchi, Federico

AU - Santoro, Amato

AU - Capecchi, Pier Leopoldo

AU - Joglar, Jose A

AU - Rosenblatt, Anna G

AU - Zardini, Marco

AU - Bricoli, Serena

AU - Bonura, Rosario

AU - Echarte-Morales, Julio

AU - Benito-González, Tomás

AU - Minguito-Carazo, Carlos

AU - Fernández-Vázquez, Felipe

AU - Wan, Elaine Y

PY - 2021/3

Y1 - 2021/3

N2 - 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.

AB - 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.

KW - Aged

KW - Arrhythmias, Cardiac/epidemiology

KW - COVID-19/epidemiology

KW - Cardiac Electrophysiology/trends

KW - Comorbidity

KW - Electrophysiologic Techniques, Cardiac/trends

KW - Female

KW - Global Health/trends

KW - Health Care Surveys

KW - Healthcare Disparities

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Practice Patterns, Physicians'/trends

KW - Prevalence

KW - Prognosis

KW - Retrospective Studies

KW - Risk Assessment

KW - Time Factors

U2 - 10.1161/CIRCEP.120.009458

DO - 10.1161/CIRCEP.120.009458

M3 - SCORING: Journal article

C2 - 33554620

VL - 14

JO - CIRC-ARRHYTHMIA ELEC

JF - CIRC-ARRHYTHMIA ELEC

SN - 1941-3149

IS - 3

M1 - e009458

ER -