Notes

Anticoagulation tactics along with risk of hemorrhaging situations throughout severely ill COVID-19 patients.
Cardiac implantable electronic device (CIED) recipients could have an unfavorable prognosis if infected with the novel coronavirus (COVID-19). We aimed to analyze the data daily transmitted by the Home Monitoring (HM) system (BIOTRONIK, Berlin, Germany) of CIEDs during the infection.

We identified CIED patients followed with the HM who experienced COVID-19 clinical manifestations. GSK2193874 order The daily trends of the following HM variables were analyzed mean heart rate (HR), physical activity, thoracic impedance (TI), ventricular and atrial arrhythmic burden.

The study cohort included 10 CIED patients (median age 90 [84-92] years, male 90%) with acute respiratory syndrome. The HR showed an increase of a value ranging from 10 to 30bpm well in advance of the severe clinical manifestations. The physical activity was generally low during the entire infection course. The TI decreased in patients presented with pulmonary edema, but increased significantly (8 to 25Ω) in most COVID-19 patients (8 out of 10) suggesting an association with pulmonary fibrosis. Arrhythmic complications were also found in half of the patients.

The trends of HR and TI in CIEDs recipients infected by the COVID-19 often showed early recurrent patterns before adverse clinical manifestations.
The trends of HR and TI in CIEDs recipients infected by the COVID-19 often showed early recurrent patterns before adverse clinical manifestations.
There are limited data on the outcomes of adults with coronavirus disease 2019 (COVID-19) and atrial fibrillation (AF). The objectives were to (i) examine associations between AF, 30-day thromboembolic events and mortality in adults with COVID-19 and (ii) examine associations between COVID-19, 30-day thromboembolic events and mortality in adults with AF.

A study was conducted using a global federated health research network. Adults aged ≥50years who presented to 41 participating healthcare organizations between 20 January 2020 and 1 September 2020 with COVID-19 were included.

For the first objective, 6589 adults with COVID-19 and AF were propensity score matched for age, gender, race, and comorbidities to 6589 adults with COVID-19 without AF. The survival probability was significantly lower in adults with COVID-19 and AF compared to matched adults without AF (82.7% compared to 88.3%, Log-Rank test
<.0001; Risk Ratio (95% confidence interval) 1.61 (1.46, 1.78)) and risk of thromboembolic events was higher in patients with AF (9.9% vs 7.0%, Log-Rank test
<.0001; Risk Ratio (95% confidence interval) 1.41 (1.26, 1.59)). For the second objective, 2454 adults with AF and COVID-19 were propensity score matched to 2454 adults with AF without COVID-19. The survival probability was significantly lower for adults with AF and COVID-19 compared to adults with AF without COVID-19, but there was no significant difference in risk of thromboembolic events.

AF could be an important risk factor for short-term mortality with COVID-19, and COVID-19 may increase risk of short-term mortality amongst adults with AF.
AF could be an important risk factor for short-term mortality with COVID-19, and COVID-19 may increase risk of short-term mortality amongst adults with AF.Although implantable cardioverter defibrillators (ICDs) are a powerful preventive therapy for cardiac sudden death, there are some populations in whom ICDs cannot be applied because of a lack of a definitive indication (grey-zone patients), such as in patients during the acute phase of cardiac injury with a susceptible risk for lethal arrhythmias. In such patients, wearable cardioverter defibrillators (WCDs) provide safer bridging period during the acute phase until the final decision-making for the ICD use and it may eliminate any inappropriate overuse of ICDs in the subacute phase. The JCS/JHRS practical guidelines provide the criteria for WCD use in Japan. Nevertheless, the evidence for that is totally limited in Japan and is dependent on the accumulation of actual real-world data from other countries in order to be able to discuss the appropriate criteria for WCD use. This study will be conducted retrospectively and/or prospectively, and is an observational and multicenter study among Japanese institutions (J-WCDR, Japan WCD Registry). This will provide evidence for WCD use in our own country and contribute to upcoming updates for the future guideline revisions.
Elderly patients having a permanent pacemaker frequently have atrial remodeling. We examined the association between routine biomarkers and atrial fibrillation (AF) in patients receiving a dual-chamber pacemaker for sinus node disease (SND) or second-/third-degree atrioventricular block.

We recorded clinical, laboratory, and electrocardiographic parameters as well as pacemaker lead parameters at implantation. The final analysis included 217 patients with SND and 393 patients with atrioventricular block. Notably, 102/217 (47%) of the SND patients (median age 77years, 54% men) and 54/393 (14%) of the atrioventricular block patients (median age 79years, 54% men) had AF history (paroxysmal or persistent).

Multivariable analysis showed that red blood cell distribution width (RDW) (OR 1.17; 95% CI 1.05-1.36;
=.05) and serum γ-glutamyl transferase (γGT) levels (OR 1.15; 95% CI 1.03-1.28;
=.04) were independently associated with AF history in patients with SND. In ROC curve analysis, the area under the curve (AUC) was 0.648;
<.01 for RDW, and 0.753;
<.01 for γGT. A RDW cut-off point of 14 was associated with AF with a sensitivity of 67% and a specificity of 68%, while a γGT cut-off point of 21 was associated with AF with a sensitivity of 80% and a specificity of 65%. In patients with second-/third-degree atrioventricular block, there were no significant independent correlations between AF and the parameters studied.

In elderly patients with SND, RDW and γGT have an independent association with AF history. Our study failed to show any corresponding associations in patients with advanced disorders of atrioventricular conduction.
In elderly patients with SND, RDW and γGT have an independent association with AF history. Our study failed to show any corresponding associations in patients with advanced disorders of atrioventricular conduction.
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