Features of Atrial Fibrillation Pathogenesis and Prognosis in Chronic Obstructive Pulmonary Patients during the COVID-19 Pandemic

Abstract

Background: Atrial fibrillation (AF) is observed in arterial hypertension, heart failure, ischemic heart disease, and pulmonary pathology, particularly, chronic obstructive pulmonary disease (COPD). COPD in turn is a risk factor for developing these cardiovascular diseases and various arrhythmias. In the coronavirus disease (COVID) situation, such comorbid patients are the most vulnerable group with a high risk of adverse outcomes. The relevance of the relationship between COPD and coronavirus infection is explained by the similarity of clinical and pathophysiological manifestations, creating more difficulties in diagnosing and determining rational treatment. The aim of the current study is to explore the role COPD plays in the onset and progression of AF, especially in the situation of COVID-19. Methods: We searched PubMed databases and included studies with information on comorbid patients suffering from COPD and AF, as well as similar patients in the context of COVID-19. Results: A modern view on the problem of comorbidity of COPD and AF is presented. In the presence of cardiorespiratory comorbidity, symptoms of mutual worsening of the clinical course are observed, due to the commonality of some links of pathogenesis, including hypoxia, hemodynamic disturbances, activation of the sympathoadrenal system, systemic inflammation, and development of fibrosis, leading to myocardial remodeling, a decrease in the effectiveness of the therapy, and a worsening prognosis, especially in the context of COVID-19. Conclusions: The results of a study of the features of the pathogenesis and course of AF in COPD are presented, as well as the formation and progression of this comorbid pathology in the context of the COVID-19 pandemic.

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

“…Secondly, the retrospective design could have introduced potential inaccuracies in the data collected from medical records and resulted in a lack of detailed information on treatment decisions following arrhythmic diagnoses, potentially affecting the assessment of clinical relevance. Furthermore, we did not assess a possible association of SARS-CoV-2 infection with arrhythmic findings as described in previous studies that investigated the impact of COVID-19 on arrhythmic events 30–33 . The follow-up duration of the study varied among patients, with a median value of approximately 1 year.…”

“…Furthermore, we did not assess a possible association of SARS-CoV-2 infection with arrhythmic findings as described in previous studies that investigated the impact of COVID-19 on arrhythmic events. [30][31][32][33] The follow-up duration of the study varied among patients, with a median value of approximately 1 year. A longer follow-up duration could provide a more comprehensive understanding of the temporal patterns of arrhythmic events.…”