Irregular Heartbeat May Increase COVID-19 Risk

Heart Chambers Illustration

4 chambers of the heart: right atrium, right ventricle, left atrium, left ventricle. Credit: Copyright American Heart Association

Previous studies have shown higher death rates in COVID-19 patients with evidence of heart damage. Heart damage can manifest as abnormal heart rhythms such as atrial fibrillation and atrial flutter. Atrial fibrillation is the most common form of heart arrhythmias and is an independent risk factor for death, especially in critically ill patients.

This study reviewed the prevalence and outcomes of hospitalized COVID-19 patients with atrial fibrillation and atrial flutter. Researchers reviewed medical records of 435* patients in the Yale Cardiovascular COVID Registry, who were adults, ages 18 and older (mean age 68.2 years; >50% were male) hospitalized between March and June 2020 in the Yale New Haven Health System. *Please note: This news release includes updated data compared to the abstract.

The data for the first 435 patients included in the registry revealed that 7.8% patients were diagnosed with atrial fibrillation/flutter for the first time in their lives, and 15.9% of the patients had a prior history of these types of arrhythmia. Overall, about one fifth of the patients had an episode of atrial fibrillation/flutter during hospitalization.

Additional analysis on the outcomes of the patients with atrial fibrillation/flutter showed that patients with a prior history of atrial fibrillation/flutter had a significantly higher risk of death or ICU mortality, independent of other health issues related to the heart, kidneys and lungs. Data also indicated in-hospital atrial arrhythmias were significantly associated with even higher risk of death and ICU mortality, as well as multi-organ failure, such as respiratory failure and renal failure.

“Our study suggests that the combination of COVID-19 and atrial arrhythmias may create a pathologic synergy that markedly increases the risk for major adverse cardiac events and death,” said Zaniar Ghazizadeh, M.D., a lead author of the study and an internal medicine resident at Yale New Haven Hospital/Yale School of Medicine in New Haven, Connecticut. “COVID-19 places patients at a high risk for abnormal heart rhythms that are, in turn, associated with markedly worse outcomes including death and multi-organ failure. Patients and physicians need to monitor for these arrhythmias closely and treatments needs to be timely.”

The researchers also cite the need for more investigation to understand the mechanisms of heart injury from COVID-19 infection and methods to prevent this complication.

Prevalence and Outcomes Among Hospitalized Patients With Covid-19 and Atrial Fibrillation or Flutter (Presentation P2355)

Authors are Zaniar Ghazizadeh, M.D.; Chad Gier, M.D.; Avinainder Singh, M.D., M.M.Sc.; Lina Vadlamani, M.S., M.B.A.; Maxwell Eder, M.D.; Justin Pacor, M.D.; Jakob Park, M.D.; Manan Pareek, M.D., Ph.D.; Zain Ahmed, M.D., M.P.H., M.S.; Kim G. Smolderen, Ph.D.; Judith Lynne Meadows, M.D., M.P.H.; Tariq Ahmad, M.D., M.P.H.; Nihar R. Desai, M.D., M.P.H.; Rachel .J Lampert, M.D.; and James V. Freeman, M.D., M.P.H. The authors’ disclosures are detailed in the abstract. No external funding sources were noted for this study.

Note: Session: EA.APS.25 – Atrial Fibrillation: Screening, Risk Factors, & Ablation Techniques and Outcomes

As the COVID-19 pandemic continues to affect people around the globe, research is ongoing to facilitate a greater understanding of the virus to improve patient care and outcomes. Heart health and medications and the potential role each have on patients with COVID-19 have been the focus of hundreds of studies. The American Heart Association will host experts presenting the latest COVID-19 research at its Scientific Sessions 2020. The meeting will be held virtually, Friday, November 13 – Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.

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