B-po04-051 device-detected atrial fibrillation during the covid-19 pandemic

Remote monitoring allows for timely assessment of device-detected atrial fibrillation (AF). Little is known regarding the effects of the COVID-19 pandemic on the occurrence of AF. To determine the association between the COVID-19 pandemic and AF occurrence in individuals with cardiac implantable electronic devices (CIEDs). We undertook a multi-center, observational, cohort study over a 100-day period during the COVID-19 pandemic (COVID-19) in the USA Remote monitoring was used to assess AF episodes in patients with a CIED (pacemaker or defibrillator; 20 centers, 13 states). For comparison, the identical 100-day period in 2019 was used (Control). The primary outcomes were AF occurrence during the COVID-19 pandemic, and the association of the pandemic with AF occurrence, as compared to one year prior. The secondary outcome was the association of AF occurrence with per-state COVID-19 prevalence. During COVID-19, 10,346 CIEDs with an atrial lead were monitored. There were 16,570 AF episodes of ≥6 minutes transmitted (16 events per 1000-patient-days) with a significant increase in proportion of patients with AF episodes in high COVID-19 prevalence states compared with low prevalence states (OR 1 34, 95% CI 1 21-1 48, p<0 001). There were significantly more AF episodes during the COVID-19 period compared with the Control period (IRR 1 33, 95% CI 1 25-1 40, p<0 001). This relationship persisted for AF episodes ≥1 hour (IRR 1 65, 95% CI 1 53-1 79, p<0 001) and ≥6 hours (IRR 1 54, 95% CI 1 38-1 73, p<0 001). During the first 100 days of COVID-19, a 33% increase in AF episodes occurred with a 34% increase in the proportion of patients with AF episodes observed in states with higher COVID-19 prevalence. These findings suggest a possible association between pandemic-associated social disruptions and AF in patients with CIEDs.