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Worldwide Survey of Covid-19-Associated Arrhythmias Publisher Pubmed



Coromilas EJ1 ; Kochav S1 ; Goldenthal I1 ; Biviano A1 ; Garan H1 ; Goldbarg S2 ; Kim JH2 ; Yeo I2 ; Tracy C3 ; Ayanian S3 ; Akar J4 ; Singh A4 ; Jain S4 ; Zimerman L5 Show All Authors
Authors
  1. Coromilas EJ1
  2. Kochav S1
  3. Goldenthal I1
  4. Biviano A1
  5. Garan H1
  6. Goldbarg S2
  7. Kim JH2
  8. Yeo I2
  9. Tracy C3
  10. Ayanian S3
  11. Akar J4
  12. Singh A4
  13. Jain S4
  14. Zimerman L5
  15. Pimentel M5
  16. Osswald S6
  17. Twerenbold R6
  18. Schaerli N6
  19. Crotti L7, 8
  20. Fabbri D7, 8
  21. Parati G7, 8
  22. Li Y9
  23. Atienza F10, 11
  24. Zatarain E10, 11
  25. Tse G12, 13, 14
  26. Leung KSK15
  27. Guevaravaldivia ME16
  28. Riverasantiago CA16
  29. Soejima K17
  30. De Filippo P18
  31. Ferrari P18
  32. Malanchini G18
  33. Kanagaratnam P19
  34. Khawaja S19
  35. Mikhail GW19
  36. Scanavacca M20
  37. Abrahao Hajjar L20
  38. Rizerio B20
  39. Sacilotto L20
  40. Mollazadeh R21
  41. Eslami M21
  42. Laleh Far V21
  43. Mattioli AV22
  44. Boriani G22
  45. Migliore F23
  46. Cipriani A23
  47. Donato F23
  48. Compagnucci P24
  49. Casella M24
  50. Dello Russo A24
  51. Coromilas J25
  52. Aboyme A25
  53. Obrien CG26
  54. Rodriguez F27
  55. Wang PJ27
  56. Naniwadekar A28
  57. Moey M28
  58. Kow CS29
  59. Cheah WK30
  60. Auricchio A31
  61. Conte G31
  62. Hwang J32
  63. Han S32
  64. Lazzerini PE33, 34
  65. Franchi F33, 34
  66. Santoro A33, 34
  67. Capecchi PL33, 34
  68. Joglar JA35
  69. Rosenblatt AG35
  70. Zardini M36
  71. Bricoli S36
  72. Bonura R36
  73. Echartemorales J37
  74. Benitogonzalez T37
  75. Minguitocarazo C37
  76. Fernandezvazquez F37
  77. Wan EY1
Show Affiliations
Authors Affiliations
  1. 1. Department of Medicine, Division of Cardiology, Columbia University, Vagelos College of Physicians & Surgeons, United States
  2. 2. New York Presbyterian Queens, Weill Medical College, United States
  3. 3. George Washington University, School of Medicine & Health Sciences, Gw Medical Faculty Associates, Washington, DC, United States
  4. 4. Section of Cardiovascular Disease, Yale University, School of Medicine, New Haven, CT, United States
  5. 5. Hospital de Clinicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Brazil
  6. 6. Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Switzerland
  7. 7. Istituto Auxologico Italiano, Irccs, Department of Cardiovascular, Neural & Metabolic Sciences, San Luca Hospital, Milan, Italy
  8. 8. Department of Medicine & Surgery, University of Milano-Bicocca, Milan, Italy
  9. 9. Wuhan Asia General Hospital, China
  10. 10. Department of Cardiology, Hospital General Universitario Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), Spain
  11. 11. Cibercv, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos Iii, Madrid, Spain
  12. 12. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, China
  13. 13. School of Life Sciences, Hospital Authority of Hong Kong, Hong Kong
  14. 14. Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong
  15. 15. Aston Medical School, Aston University, Birmingham, United Kingdom
  16. 16. Umae Hospital de Especialidades Dr. Antonio Fraga Mouret Cmn la Raza Imss Cdmx, Mexico
  17. 17. Kyorin University, School of Medicine, Tokyo, Japan
  18. 18. Electrophysiology & Cardiac Pacing Unit, Cardiology Department, Asst Papa Giovanni Xxiii, Bergamo, Italy
  19. 19. Imperial College Healthcare Nhs Trust, London, United Kingdom
  20. 20. Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil
  21. 21. Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran
  22. 22. University of Modena & Reggio Emilia, Modena, Italy
  23. 23. Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy
  24. 24. Cardiology & Arrhythmology Clinic, University Hospital Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
  25. 25. Division of Cardiovascular Disease & Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
  26. 26. Department of Medicine, Division of Cardiology, University of California, San Francisco School of Medicine, United States
  27. 27. Division of Cardiology, Stanford University, CA, United States
  28. 28. East Carolina University, Greenville, NC, United States
  29. 29. School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
  30. 30. Department of Medicine, Clinical Research Center, Taiping Hospital, Perak, Malaysia
  31. 31. Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
  32. 32. Division of Cardiology, Department of Internal Medicine, Keimyung University, Dongsan Hospital, Daegu, South Korea
  33. 33. Department of Medical Sciences, Surgery & Neurosciences, University of Siena, Italy
  34. 34. Azienda Ospedaliera Universitaria Senese (AOUS), Siena, Italy
  35. 35. University of Texas Southwestern Medical Center, Dallas, United States
  36. 36. Division of Cardiology, University Hospital Ospedale Maggiore, Parma, Italy
  37. 37. Department of Cardiology, University Hospital, Leon, Spain

Source: Circulation: Arrhythmia and Electrophysiology Published:2021


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. © 2021 American Heart Association, Inc.
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