Features of sinus rhythm restoration in patients with paroxysmal and persistent non-valvular atrial fibrillation and previous COVID-19 infection in iron-deficiency anaemia

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. Currently, there are conclusive data in the literature on the effect of reduced haemoglobin concentration on sinus rhythm restoration in patients with nonvalvular atrial fibrillation. It is relevant to study the features of rhythm restoration in patients with anaemia and atrial fibrillation in COVID-19 infection.

Aim. To study the effects of iron-deficiency anaemia on sinus rhythm restoration rate and the dose of amiodarone required for this in patients with paroxysmal and persistent non-valvular atrial fibrillation and previous COVID-19 infection.

Material and methods. The study included 63 patients aged between 53 and 94 years (mean age 60.8±10.9 years): 26 men (41.3%) and 37 women (58.7%). The patients were divided into groups according to the presence of anaemia and computed tomography staging (CT severity score) of lung damage. Criteria for inclusion: paroxysmal or persistent non-valvular atrial fibrillation; previous COVID-infection (according to the documents, medical records). We took into account medical histories, laboratory and instrumental findings, as well as treatment. The statistical analysis was performed by using the Statistica 13.3 software. The obtained data were presented as M±σ or Me [Q1; Q3]. The differences between the indicators were assessed using Student’s t test, the Mann–Whitney U test and the Kruskal–Wallis H test. Nominal variables were compared by using Pearson’s χ2 test with Yates correction or Fisher’s criterion. The relationship between the parameters was assessed using the Pearson’s or Spearman’s correlation coefficient. A p <0.05 was considered statistically significant.

Results. The patients with normal haemoglobin concentration restored sinus rhythm for 10 [4; 13] hours and the patients with iron-deficiency anaemia — for 5.5 [2; 10] hours (p=0.044). In patients with COVID-19 pneumonia, we found a direct correlation between the degree of lung damage and the dose of amiodarone (r=0.33, p <0.05), as well as the time of sinus rhythm restoration (r=0.48, p <0.05).

Conclusion. The presence of iron-deficiency anaemia in patients with previous COVID-19 infection and paroxysmal and persistent non-valvular atrial fibrillation is associated with a shorter time and a lower dose of amiodarone required for successful sinus rhythm restoration in comparison to patients with normal haemoglobin concentration; in patients with more severe lung damage caused by COVID-19 pneumonia, it takes more time and a large dose of amiodarone for sinus rhythm restoration.

Full Text

Restricted Access

About the authors

Marat K Valeev

Pestrechinsky Central District Hospital

Author for correspondence.
Email: vmh89@mail.ru
ORCID iD: 0000-0002-0570-0220

MD, Director, Central regional hospital

Russian Federation, Pestretsy, Russia

Niyaz R Khasanov

Kazan State Medical University

Email: ybzp@mail.ru
ORCID iD: 0000-0002-7760-0763

MD, D.Sc. (Med.), Prof., Head, Depart. of propaedeutics of internal diseases named after Prof. S.S. Zimnitsky

Russian Federation, Kazan, Russia

References

  1. Ara­kelyan MG, Bockeria LA, Vasilieva EYu, Golitsyn SP, Golukhova EZ, Gorev MV, Davtyan KV, Drapkina OM, Kropacheva ES, Kuchinskaya EA, Lajovich LYu, Miro­nov NYu, Mishina IE, Panchenko EP, Revishvili ASh, Rzayev FG, Tatarsky BA, Utsumueva MD, Shakhmatova OO, Shlevkov NB, Shpektor AV, Andreev DA, Artyukhina EA, Barbarash OL, Galyavich AS, Duplyakov DV, Zenin SA, Lebedev DS, Mikhailov EN, Novikova NA, Popov SV, Filatov AG, Shlyakhto EV, Shubik YuV. 2020 Clinical guidelines for Atrial fibrillation and atrial flutter. Russian Journal of Cardiology. 2021;26(7):4594. (In Russ.) doi: 10.15829/1560-4071-2021-4594.
  2. Shilov M, Mel'nik MV, Osiya AO, Sviridova AYu, Mel’nik NV. Pathophysiology and principles of treatment of atrial fibrillation. Russkiy meditsinskiy zhurnal. 2011;(14):877–883. (In Russ.)
  3. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, Boriani G, Castella M, Dan G-A, Dilaveris PE, Fauchier L, Filippatos G, Kalman JM, La Meir M. 2020 ESC Guidelines for the diagnosis and ma­nagement of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–498. doi: 10.1093/eurheartj/ehaa612.
  4. Desai AD, Boursiquot BC, Melki L, Wan EY. Management of arrhythmias associated with COVID-19. Curr Cardiol Rep. 2020;23(1):2. doi: 10.1007/s11886-020-01434-7.
  5. Liu J, Liu S. The management of coronavirus disease 2019 (COVID-19). J MedVirol. 2020;92(9):1484–1490. doi: 10.1002/jmv.25965.
  6. Blain H, Rolland Y, Benetos A, Giacosa N, Albrand M, Miot S, Bousquet J. Atypical clinical presentation of COVID-19 infection in residents of a long-term care facility. Eur Geriatr Med. 2020;11(6):1085–1088. doi: 10.1007/s41999-020-00352-9.
  7. Temporary guidelines of the Ministry of Health of the Russian Federation “Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)”. Version 11 (07.05.2021). https://minzdrav.gov.ru/ministry/med_covid19 (access date: 01.07.2021). (In Russ.)
  8. Manolis A, Manolis AA, Manolis TA, Aposto­lopoulos EJ, Papatheou D, Melita H. COVID-19 infection and cardiac arrhythmias. Trends Cardiovasc Med. 2020;30(8):451–460. doi: 10.1016/j.tcm.2020.08.002.
  9. Romiti GF, Corica B, Lip GYH, 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.
  10. García-Granja PE, Veras C, Aparisi Á, Amat-Santos IJ, Catalá P, Marcos M, Cabezón G, Candela J, Gil JF, Uribarri A, Revilla A, Carrasco M, Gómez I, San Román JA. Atrial fibrillation in patients with SARS-CoV-2 infection. Med Clin (Barc). 2021;157(2):58–63. doi: 10.1016/j.medcli.2021.01.003.
  11. Kopina MN, Gaevskij YuG. Hypercoagulation disorders of hemostasis in patients with newly diagnosed iron deficiency anemia. Vestnik Novgorodskogo gosudarstvennogo universiteta im Yaroslava Mudrogo. 2013;1(71):21–24. (In Russ.)
  12. Taneri PE, Gómez-Ochoa SA, Llanaj E, Raguindin PF, Rojas LZ, Roa-Díaz ZM, Salvador DJr, Groothof D, Minder B, Kopp-Heim D, Hautz WE, Eisenga MF, Franco OH, Glisic M, Muka T. Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis. Eur J Epidemiol. 2020;35(8):763–773. doi: 10.1007/s10654-020-00678-5.
  13. Cho IJ, Mun YC, Kwon KH, Shin GJ. Effect of anemia correction on left ventricular structure and filling pressure in anemic patients without overt heart disease. Korean J Intern Med. 2014;29(4):445–453. doi: 10.3904/kjim.2014.29.4.445.
  14. Sutil-Vega M, Rizzo M, Martínez-Rubio A. Anemia and iron deficiency in heart failure: a review of echocardiographic features. Echocardiography. 2019;36(3):585–594. doi: 10.1111/echo.14271.
  15. Nekrasova TA, Strongin LG, Ledentsova OV. Hematolo­gical disturbances in subclinical hypothyroidism and their dynamics during substitution therapy. Klinicheskaya medi­tsina. 2013;91(9):29–33. (In Russ.)

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

© 2022 Eco-Vector




This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies