Antiarrhythmic therapy for atrial fibrillation in patients with the novel SARS-CoV-2 coronavirus infection: how to make the right choice?
- Authors: Tarzimanova A.I1, Bykova E.E1
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Affiliations:
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- Issue: Vol 28, No 13 (2021)
- Pages: 69-73
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/313315
- DOI: https://doi.org/10.18565/pharmateca.2021.13.69-73
- ID: 313315
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Abstract
The novel SARS-CoV-2 coronavirus infection (COVID-19) has become one of the global problems of the modern world community. An analysis of the factors associated with the severe course and poor prognosis of COVID-19 indicates an important role for comorbid pathology. Cardiac arrhythmias are one of the most common cardiovascular complications of coronavirus infection, and both supraventricular and ventricular arrhythmias can be diagnosed on an ECG. The most common arrhythmia in COVID-19 is atrial fibrillation (AF); in some patients, newly diagnosed AF cases occur during the acute course of coronavirus infection or in the first months after hospital discharge. It has been shown that the prevalence of AF among patients with coronavirus infection is approximately 2 times higher than in the general population, and reaches 8%. The onset of AF leads to an increase in thromboembolic complications and worsens the prognosis of patients with COVID-19. At the same time, the severity of coronavirus infection directly affects the incidence of AF. The administration of anticoagulant therapy is one of the most important directions in the treatment of patients with novel SARS-CoV-2 coronavirus infection. Anticoagulant therapy is indicated for all COVID-19 patients with newly diagnosed AF or a history of AF without exception. The drugs of IC and III classes are recommended to restore sinus rhythm in AF paroxysm in patients with stable hemodynamics. The choice of an antiarrhythmic drug for the relief and prevention of AF in patients with SARS-CoV-2 coronavirus infection should be based on an assessment of the severity of damage to the cardiovascular system.
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About the authors
A. I Tarzimanova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: tarzimanova@mail.ru
Dr. Sci. (Med.), Professor at the Department of Faculty Therapy № 2
E. E Bykova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
References
- Министерство здравоохранения РФ «Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 12 (21.09.2021).
- Чазова И.Е., Миронова О.Ю. COVID-19 и сердечно-сосудистые заболевания. Терапевтический архив. 2020;9(9):4-7. doi: 10.26442/00403660.2020. 09.000742.
- Гриневич В.Б., Губонина И.В., Дощицин В.Л. и др. Особенности ведения коморбидных пациентов в период пандемии новой коронавирусной инфекции (COVID-19). Национальный консенсус, 2020. Кардиоваскулярная терапия и профилактика. 2020;19(4):2630. doi: 10.15829/1728-8800-2020-2630.
- Rom it i G.F., Corica B., Lip G.Y.H., Proietti M. Prevalence and Impact of Atrial Fibrillation in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis. J. Clin Med. 2021;10(11):2490. Doi: 10.3390/ jcm10112490.
- Bhatia K.S., Sritharan H.P., Chia J. et al. Cardiac Complications in Patients Hospitalised With COVID-19 in Australia. Heart Lung Circ. 2021 Sep 1:S1443-9506(21)01193-98. Doi: 10.1016/j. hlc.2021.08.001.
- Wang D., Hu B., Hu C., et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-69. Doi:10.1001/ jama.2020.1585.
- Colon C.M., Barrios J.G., Chiles J.W., et al. Atrial Arrhythmias in COViD-19 Patients. JACC Clin Electrophysiol. 2020 Sep;6(9):1189-90. doi: 10.1016/j.jacep.2020.05.015.
- ESC Guidance for the Diagnosis and Management of CV Disease during the COViD-19 Pandemic. URL: https://www.escardio.org/Education/COViD-19-and-Cardiology/ESC-COViD-19-Guidance
- Hindricks G., Potpara T., Dagres N., et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2020;ehaa612. doi: 10.1093/eurheartj/ ehaa612.
- Kirchhof P., Camm A.J., Goette A., et al. Early rhythm-control therapy in patients with atrial fibrillation. N. Engl J. Med; 2020 Oct 1;383(14):1305-16. doi: 10.1056/NEJMoa2019422.
- Тарасов А.В., Косых С.А., Бушуева Е.В. и др. Сравнение эффективности инъекционных форм антиаритмических препаратов пропафенона и амиодарона при проведении фармакологической кардиоверсии пароксизмальной фибрилляции предсердий. Consilium Medicum. 2019;2(1):81-6.
- Khan I.A. Single oral loading dose of propafenone for pharmacological cardioversion of recent-onset atrial fibrillation. J. Am Coll Cardiol. 2001;37(2):542-47. doi: 10.1016/s0735-1097(00)01116-15.
- Heldal M., Atar D. Pharmacological conversion of recent-onset atrial fibrillation: a systematic review. Scand Cardiovasc J. Suppl. 2013;47:2-10. doi: 10.3109/14017431.2012.740572.
- Подзолков В.И., Тарзиманова А.И. Пропафенон в лечении нарушений ритма сердца. Кардиология 2012;5:70-3.
- Kochiadakis G.E., Igoumenidis N.E., Hamilos M.E., et al. A comparative study of the efficacy and safety of procainamide versus propafenone versus amiodarone for the conversion of recent-onset atrial fibrillation. Am J. Cardiol. 2007;99:1721-25 doi: 10.1016/j.amjcard.2007.01.059.
- Andrade J.G., MacGillivray J., Macle L., et al. Clinical effectiveness of a systematic «pill-in-the-pocket» approach for the management of paroxysmal atrial fibrillation. Heart Rhythm. 2018;15(1):9-16. doi: 10.1016/j.hrthm.2017.10.002.
- Миллер О.Н., Старичков С.А., Поздняков Ю.М. и др. Эффективность и безопасность применения пропафенона (пропанорма) и амиодарона (кордарона) у больных с фибрилляцией предсердий на фоне артериальной гипертонии, ишемической болезни сердца и хронической сердечной недостаточности с сохраненной систолической функцией левого желудочка. Российский кардиологический журнал. 2010;4(84):56-72.
- Valembois L., Audureau E., Takeda A., et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2019;9(9):CD005049. doi: 10.1002/14651858.CD005049.pub5.
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