Talaei Fahimeh, Banga Akshat, Pursell Amanda, Gage Ann, Pallipamu Namratha, Seri Amith Reddy, Adhikari Ramesh, Kashyap Rahul, Surani Salim
Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ 85054, United States.
Department of Internal Medicine, Sawai Man Singh Medical College, Jaipur 302004, India.
World J Crit Care Med. 2023 Dec 9;12(5):236-247. doi: 10.5492/wjccm.v12.i5.236.
Over the last three years, research has focused on examining cardiac issues arising from coronavirus disease 2019 (COVID-19) infection, including the emergence of new-onset atrial fibrillation (NOAF). Still, no clinical study was conducted on the persistence of this arrhythmia after COVID-19 recovery. Our objective was to compose a narrative review that investigates COVID-19-associated NOAF, emphasizing the evolving pathophysiological mechanisms akin to those suggested for sustaining AF. Given the distinct strategies involved in the persistence of atrial AF and the crucial burden of persistent AF, we aim to underscore the importance of extended follow-up for COVID-19-associated NOAF. A comprehensive search was conducted for articles published between December 2019 and February 11, 2023, focusing on similarities in the pathophysiology of NOAF after COVID-19 and those persisting AF. Also, the latest data on incidence, morbidity-mortality, and management of NOAF in COVID-19 were investigated. Considerable overlaps between the mechanisms of emerging NOAF after COVID-19 infection and persistent AF were observed, mostly involving reactive oxygen pathways. With potential atrial remodeling associated with NOAF in COVID-19 patients, this group of patients might benefit from long-term follow-up and different management. Future cohort studies could help determine long-term outcomes of NOAF after COVID-19.
在过去三年中，研究聚焦于检查2019冠状病毒病（COVID-19）感染引发的心脏问题，包括新发房颤（NOAF）的出现。然而，尚无关于COVID-19康复后这种心律失常持续情况的临床研究。我们的目的是撰写一篇叙述性综述，探讨与COVID-19相关的NOAF，强调与维持房颤相似的不断演变的病理生理机制。鉴于房颤持续存在所涉及的不同策略以及持续性房颤的关键负担，我们旨在强调对与COVID-19相关的NOAF进行延长随访的重要性。我们对2019年12月至2023年2月11日发表的文章进行了全面检索，重点关注COVID-19后NOAF与持续性房颤在病理生理学上的相似之处。此外，还研究了COVID-19中NOAF的发病率、发病死亡率及管理的最新数据。观察到COVID-19感染后新发NOAF与持续性房颤的机制之间存在相当多的重叠，主要涉及活性氧途径。鉴于COVID-19患者中NOAF可能伴有心房重构，这组患者可能受益于长期随访和不同的管理。未来的队列研究有助于确定COVID-19后NOAF的长期结局。
