Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9539710.26442/20751753.2021.1.200669ArticlesСтатьиResearch ArticleFeatures of the management of patients with atrial fibrillation during the COVID-19 pandemic: current questions and possible answersОсобенности ведения пациентов с фибрилляцией предсердий во время пандемии COVID-19: актуальные вопросы и возможные ответыNapalkovDmitry A.НапалковДмитрий Александрович

д-р мед. наук, проф.

dminap@mail.ruSokolovaAnastasiya A.СоколоваАнастасия Андреевна

канд. мед. наук, доц.

SkripkaAlena I.СкрипкаАлена Игоревна

ассистент

Sechenov First Moscow State Medical University (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет)15012021231VOL 23, NO1 (2021)ТОМ 23, №1 (2021)323428122021Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/95397

This publication is devoted to the tactics of management of patients with atrial fibrillation during the pandemic of new coronavirus infection (COVID-19). Among the key issues of relevance during this period, we thought it possible to consider the epidemiology, prevalence, and pathophysiological mechanisms of atrial fibrillation in patients with COVID-19, as well as treatment strategies with regard to obvious hospitalization, rhythm control/restoration and prevention of thromboembolic events. A separate issue is the tactics regarding the prescription or continuation of therapy aimed at the prevention of thromboembolic events and possible drug interactions in patients treated for COVID-19 and receiving anticoagulant therapy with direct oral anticoagulants for atrial fibrillation.

Данная публикация посвящена тактике ведения пациентов с фибрилляцией предсердий во время пандемии новой коронавирусной инфекции (COVID-19). Среди ключевых вопросов, актуальных в данный период времени, мы посчитали возможным рассмотреть эпидемиологию, распространенность и патофизиологические механизмы развития фибрилляции предсердий у пациентов с COVID-19, а также лечебные стратегии в отношении необходимой госпитализации, контроля/восстановления ритма и профилактики тромбоэмболических осложнений. Отдельным вопросом рассматривается тактика в отношении назначения или продолжения терапии, направленной на профилактику тромбоэмболических осложнений и возможных неблагоприятных межлекарственных взаимодействий у пациентов, проходящих лечение от COVID-19 и получающих антикоагулянтную терапию прямыми оральными антикоагулянтами по поводу фибрилляции предсердий.

COVID-19atrial fibrillationCOVID-19thromboembolic eventsanticoagulant therapyфибрилляция предсердийтромбоэмболические осложненияантикоагулянтная терапияWang 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): 1061-9. DOI: 10.1001/jama.2020.1585Bhatla A, Mayer MM, Adusumalli S, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm 2020; 17 (9): 1439-44. DOI: 10.1016/j.hrthm.2020.06.016Inciardi RM, Adamo M, Lupi L, et al. Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J 2020; 41 (19): 1821-9. DOI: 10.1093/eurheartj/ehaa388Gopinathannair R, Merchant FM, Lakkireddy DR, et al. COVID-19 and cardiac arrhythmias: a global perspective on arrhythmia characteristics and management strategies. J Interv Card Electrophysiol 2020; 59 (2): 329-36. DOI: 10.1007/s10840-020-00789-9Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA 2020; 323 (18): 1775-6. DOI: 10.1001/jama.2020.4683Gawatko M, Kapton-Cieslicka A, Hohl M, et al. COVID-19 associated atrial fibrillation: Incidence, putative mechanisms and potential clinical implications. Int J Cardiol Heart Vasc 2020; 30: 100631. DOI: 10.1016/j.ijcha.2020.100631Sala S, Peretto G, De Luca G, et al. Low prevalence of arrhythmias in clinically stable COVID-19 patients. Pacing Clin Electrophysiol 2020; 43 (8): 891-93. DOI: 10.1111/pace.13987Chen D, Li X, Song Q, et al. Assessment of Hypokalemia and Clinical Characteristics in Patients With Coronavirus Disease 2019 in Wenzhou, China. JAMA Netw Open 2020; 3 (6): e2011122. DOI: 10.1001/jamanetworkopen.2020.11122Mujovic N, Dobrev D, Marinkovic M, et al. The role of amiodarone in contemporary management of complex cardiac arrhythmias. Pharmacol Res 2020; 151: 104521. DOI: 10.1016/j.phrs.2019.104521Delle Karth G, Geppert A, Neunteufl T, et al. Amiodarone versus diltiazem for rate control in critically ill patients with atrial tachyarrhythmias. Crit Care Med 2001; 29 (6): 1149-53. DOI: 10.1097/00003246-200106000-00011Available at: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Gui-dance. Accessed: 10.06.2020Ribes A, Vardon-Bounes F, Memier V, et al. Thromboembolic events and Covid-19. Adv Biol Regul 2020; 77: 100735. DOI: 10.1016/j.jbior.2020.100735Iba T, Levy JH, Wada H, et al. Subcommittee on Disseminated Intravascular Coagulation. Differential diagnoses for sepsis-induced disseminated intravascular coagulation: communication from the SSC of the ISTH. J Thromb Haemost 2019; 17 (2): 415-9. DOI: 10.1111/jth.14354Magro C, Mulvey JJ, Berlin D, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: A report of five cases. Transl Res 2020; 220: 113. DOI: 10.1016/j.trsl.2020.04.007Zhang Y, Xiao M, Zhang S, et al. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med 2020; 382 (17): e38. DOI: 10.1056/NEJMc2007575Green SJ. Covid-19 accelerates endothelial dysfunction and nitric oxide deficiency. Microbes Infect 2020; 22 (4-5): 149-50. DOI: 10.1016/j.micinf.2020.05.006Russo V, Rago A, Carbone A, et al. Atrial Fibrillation in COVID-19: From Epidemiological Association to Pharmacological Implications. J Cardiovasc Pharmacol 2020; 76 (2): 138-45. DOI: 10.1097/FJC.0000000000000854Flam B, Wintzell V, Ludvigsson JF, et al. Direct oral anticoagulant use and risk of severe COVID-19. J Intern Med 2020. DOI: 10.1111/joim.13205Hu YF, Cheng WH, Hung Y, et al. Management of Atrial Fibrillation in COVID-19 Pandemic. Circ J 2020; 84 (10): 1679-85. DOI: 10.1253/circj.CJ-20-0566