Abstract Aims Advanced interatrial block (IAB), is an unrecognized surrogate of atrial dysfunction and a trigger of atrial dysrhythmias, mainly atrial fibrillation (AF). Our aim was to prospectively assess whether advanced IAB in sinus rhythm is associated with AF and stroke in elderly outpatients with structural heart disease, a group not previously studied. Methods and results Prospective observational registry that included outpatients aged ≥70 years with structural heart disease and no previous diagnosis of AF. Patients were divided into three groups: normal P-wave duration (<120 ms), partial IAB (P-wave duration ≥120 ms, positive in the inferior leads), and advanced IAB [P-wave duration ≥120 ms, biphasic (plus/minus) morphology in the inferior leads]. Among 556 individuals, 223 had normal P-wave (40.1%), 196 partial IAB (35.3%), and 137 advanced IAB (24.6%). After a median follow-up of 694 days, 93 patients (16.7%) developed AF, 30 stroke (5.4%), and 34 died (6.1%). Advanced IAB was independently associated with AF –[hazard ratio (HR) 2.9, 95% confidence interval (CI) 1.7–5.1; P < 0.001], stroke [HR 3.8, 95% CI 1.4–10.7; P = 0.010), and AF/stroke (HR 2.6, 95% CI 1.5–4.4; P = 0.001). P-wave duration (ms) was independently associated with AF (HR 1.05, 95% CI 1.03–1.07; P < 0.001), AF/stroke (HR 1.04, 95% CI 1.02–1.06; P < 0.001), and mortality (HR 1.04, 95% CI 1.00–1.08; P = 0.021). Conclusions The presence of advanced IAB in sinus rhythm is independently associated with AF and stroke in an elderly population with structural heart disease and no previous diagnosis of AF. P-wave duration was also associated with all-cause mortality.

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COVID-19 patients are susceptible to hypercoagulability. For the safe return to sports after COVID-19, athletes or individuals wanting to resume physical activity should complete screening for myocardial injury and myocarditis. In addition, patients with COVID-19 are reported at prevalence of 27% to 31% for venous thromboembolic events. The probability of deep vein thrombosis and pulmonary embolism prior to intensive exercise after COVID-19 infection should be considered. The prevalence of cardiac injury is reported at 19%, and the prevalence of deep vein thrombosis and pulmonary embolism is higher than that for myocarditis. Thus, the heart is not the only system needing screened. Examination for myocardial injury and myocarditis are mandatory. Also, deep vein thrombosis, and pulmonary thromboembolism must be considered, and when possible, blood troponin values, D-dimer prothrombin time, and activated partial thromboplastin time levels are determined for COVID-19 infection athletes or any individual before returning to sporting practice or intense physical activity or exercise.

Background The first case of COVID-19 was detected in Latin America on February 26 th , 2020, in Brazil. Later in June, the World Health Organization announced that the focus of the outbreak had shifted to Latin America, where countries already had poor control indicators of Non-Communicable Diseases (NCD). Concerns about coronavirus infection led to a reduced number of visits and hospitalizations in patients with NCD, such as cardiovascular diseases, diabetes, and cancer. There is a need to determine the impact of COVID-19 pandemic on patients with cardiometabolic diseases who do not have clinical evidence of COVID-19 infection. Methods The CorCOVID LATAM is a cross sectional survey including ambulatory cardiometabolic patients without history or evidence of COVID-19 infection. The study will be conducted by Interamerican Society of Cardiology. An online survey composed by 38 questions using Google Forms will be distributed to patients of 13 Latin American Spanish-speaking countries from June 15th to July 15th, 2020. Data will be analyzed by country and regions. Seven clusters of questions will be analyzed: demographics, socioeconomic and educational level, cardiometabolic profile, lifestyle and habits, body weight perception, medical follow-up and treatments, and psychological symptoms. Results Final results will be available upon completion of the study. Conclusion The present study will provide answers regarding the impact of COVID-19 pandemic on non-infected cardiometabolic patients. There is scarce data on this topic since it is an unprecedented hostile scenario without short-term solutions.

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