Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Особенности ведения пациентов с фибрилляцией предсердий во время пандемии COVID-19: актуальные вопросы и возможные ответы
Напалков Д.А., Соколова А.А., Скрипка А.И. Особенности ведения пациентов с фибрилляцией предсердий во время пандемии COVID-19: актуальные вопросы и возможные ответы. Consilium Medicum. 2021; 23 (1): 32–34. DOI: 10.26442/20751753.2021.1.200669
________________________________________________
Napalkov DA, Sokolova AA, Skripka AI. Features of the management of patients with atrial fibrillation during the COVID-19 pandemic: current questions and possible answers, Consilium Medicum. 2021; 23 (1): 32–34. DOI: 10.26442/20751753.2021.1.200669
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
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.
Ключевые слова: фибрилляция предсердий, COVID-19, тромбоэмболические осложнения, антикоагулянтная терапия
Ключевые слова: фибрилляция предсердий, COVID-19, тромбоэмболические осложнения, антикоагулянтная терапия
________________________________________________
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.
Keywords: atrial fibrillation, COVID-19, thromboembolic events, anticoagulant therapy
Полный текст
Список литературы
1. Wang 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.2020.1585
2. Bhatla A, Mayer MM, Adusumalli S, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm 2020; 17 (9): 1439–44. DOI: 10.1016/j.hrthm.2020.06.016
3. Inciardi 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/ehaa388
4. Gopinathannair 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/s10840-020-00789-9
5. Onder 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.2020.4683
6. Gawałko M, Kapłon-Cieślicka 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.2020.100631
7. Sala 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.13987
8. Chen 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.2020.11122
9. Mujović N, Dobrev D, Marinković M, et al. The role of amiodarone in contemporary management of complex cardiac arrhythmias. Pharmacol Res 2020; 151: 104521. DOI: 10.1016/j.phrs.2019.104521
10. Delle 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: 10.1097/00003246-200106000-00011
11. Available at: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance. Accessed: 10.06.2020
12. Ribes A, Vardon-Bounes F, Mémier V, et al. Thromboembolic events and Covid-19. Adv Biol Regul 2020; 77: 100735. DOI: 10.1016/j.jbior.2020.100735
13. Iba 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.14354
14. Magro 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: 1–13. DOI: 10.1016/j.trsl.2020.04.007
15. Zhang 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/NEJMc2007575
16. Green SJ. Covid-19 accelerates endothelial dysfunction and nitric oxide deficiency. Microbes Infect 2020; 22 (4–5): 149–50. DOI: 10.1016/j.micinf.2020.05.006
17. Russo 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.0000000000000854
18. Flam 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.13205
19. Hu 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
2. Bhatla A, Mayer MM, Adusumalli S, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm 2020; 17 (9): 1439–44. DOI: 10.1016/j.hrthm.2020.06.016
3. Inciardi 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/ehaa388
4. Gopinathannair 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/s10840-020-00789-9
5. Onder 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.2020.4683
6. Gawałko M, Kapłon-Cieślicka 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.2020.100631
7. Sala 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.13987
8. Chen 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.2020.11122
9. Mujović N, Dobrev D, Marinković M, et al. The role of amiodarone in contemporary management of complex cardiac arrhythmias. Pharmacol Res 2020; 151: 104521. DOI: 10.1016/j.phrs.2019.104521
10. Delle 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: 10.1097/00003246-200106000-00011
11. Available at: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance. Accessed: 10.06.2020
12. Ribes A, Vardon-Bounes F, Mémier V, et al. Thromboembolic events and Covid-19. Adv Biol Regul 2020; 77: 100735. DOI: 10.1016/j.jbior.2020.100735
13. Iba 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.14354
14. Magro 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: 1–13. DOI: 10.1016/j.trsl.2020.04.007
15. Zhang 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/NEJMc2007575
16. Green SJ. Covid-19 accelerates endothelial dysfunction and nitric oxide deficiency. Microbes Infect 2020; 22 (4–5): 149–50. DOI: 10.1016/j.micinf.2020.05.006
17. Russo 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.0000000000000854
18. Flam 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.13205
19. Hu 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
________________________________________________
1. Wang 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.2020.1585
2. Bhatla A, Mayer MM, Adusumalli S, et al. COVID-19 and cardiac arrhythmias. Heart Rhythm 2020; 17 (9): 1439–44. DOI: 10.1016/j.hrthm.2020.06.016
3. Inciardi 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/ehaa388
4. Gopinathannair 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/s10840-020-00789-9
5. Onder 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.2020.4683
6. Gawałko M, Kapłon-Cieślicka 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.2020.100631
7. Sala 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.13987
8. Chen 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.2020.11122
9. Mujović N, Dobrev D, Marinković M, et al. The role of amiodarone in contemporary management of complex cardiac arrhythmias. Pharmacol Res 2020; 151: 104521. DOI: 10.1016/j.phrs.2019.104521
10. Delle 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: 10.1097/00003246-200106000-00011
11. Available at: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance. Accessed: 10.06.2020
12. Ribes A, Vardon-Bounes F, Mémier V, et al. Thromboembolic events and Covid-19. Adv Biol Regul 2020; 77: 100735. DOI: 10.1016/j.jbior.2020.100735
13. Iba 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.14354
14. Magro 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: 1–13. DOI: 10.1016/j.trsl.2020.04.007
15. Zhang 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/NEJMc2007575
16. Green SJ. Covid-19 accelerates endothelial dysfunction and nitric oxide deficiency. Microbes Infect 2020; 22 (4–5): 149–50. DOI: 10.1016/j.micinf.2020.05.006
17. Russo 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.0000000000000854
18. Flam 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.13205
19. Hu 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
Авторы
Д.А. Напалков*, А.А. Соколова, А.И. Скрипка
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет), Москва, Россия
*dminap@mail.ru
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет), Москва, Россия
*dminap@mail.ru
________________________________________________
Dmitry A. Napalkov*, Anastasiya A. Sokolova, Alena I. Skripka
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*dminap@mail.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.