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https://hdl.handle.net/2440/132475
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Type: | Journal article |
Title: | Atrial fibrillation burden during the coronavirus disease 2019 pandemic |
Author: | O’Shea, C.J. Middeldorp, M.E. Thomas, G. Harper, C. Elliott, A.D. Ray, N. Campbell, K. Lau, D.H. Sanders, P. |
Citation: | Europace, 2021; 23(9):1493-1501 |
Publisher: | Oxford University Press |
Issue Date: | 2021 |
ISSN: | 1099-5129 1532-2092 |
Statement of Responsibility: | Catherine J O’Shea, Melissa E Middeldorp, Gijo Thomas, Curtis Harper, Adrian D Elliott, Noemi Ray ... et al. |
Abstract: | Aims The aim of this study is to determine the association between the coronavirus disease 2019 (COVID-19) pandemic and atrial fibrillation (AF) occurrence in individuals with cardiac implantable electronic devices (CIEDs). Method and results Multi-centre, observational, cohort study over a 100-day period during the COVID-19 pandemic (COVID-19) in the USA. Remote monitoring was used to assess AF episodes in patients with a CIED (pacemaker or defibrillator; 20 centres, 13 states). For comparison, the identical 100-day period in 2019 was used (Control). The primary outcomes were the AF burden during the COVID-19 pandemic, and the association of the pandemic with AF occurrence, as compared with 1 year prior. The secondary outcome was the association of AF occurrence with per-state COVID-19 prevalence. During COVID-19, 10 346 CIEDs with an atrial lead were monitored. There were 16 570 AF episodes of ≥6 min transmitted (16 events per 1000 patient days) with a significant increase in proportion of patients with AF episodes in high COVID-19 prevalence states compared with low prevalence states [odds ratio 1.34, 95% confidence interval (CI) 1.21–1.48, P < 0.001]. There were significantly more AF episodes during COVID-19 compared with Control [incident rate ratio (IRR) 1.33, 95% CI 1.25–1.40, P < 0.001]. This relationship persisted for AF episodes ≥1 h (IRR 1.65, 95% CI 1.53–1.79, P < 0.001) and ≥6 h (IRR 1.54, 95% CI 1.38–1.73, P < 0.001). Conclusion During the first 100 days of COVID-19, a 33% increase in AF episodes occurred with a 34% increase in the proportion of patients with AF episodes observed in states with higher COVID-19 prevalence. These findings suggest a possible association between pandemic-associated social disruptions and AF in patients with CIEDs. Clinical TRIAL registration Australian New Zealand Clinical Trial Registry: ACTRN12620000692932. |
Keywords: | Atrial fibrillation; cardiac implantable electronic device; pacemaker; defibrillator; coronavirus disease 2019; Coronavirus |
Rights: | Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. |
DOI: | 10.1093/europace/euab099 |
Published version: | http://dx.doi.org/10.1093/europace/euab099 |
Appears in Collections: | Medicine publications |
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