Risk of Subclinical Atrial Fibrillation in Patients with Cardiac Implantable Electronic Devices after COVID-19 Infection: A Single-Center Study

Abstract

Objective: To evaluate the risk of subclinical atrial fibrillation (SCAF) in patients with cardiac implantable electronic devices (CIEDs) after COVID-19 infection. Materials and Methods: The authors retrospectively enrolled patients receiving CIEDs with atrial leads at the device clinic between January 2022 and September 2023. Patients with 12-lead ECG documented atrial fibrillation, atrial flutter, or atrial tachycardia were excluded. The authors classified these patients as COVID-19 and non-COVID-19 groups. The outcome was the new onset and/or 20% increased episodes of the longest SCAF duration. The authors compared the outcome using a chi-square or Fisher’s exact test between both groups. Results: One hundred thirty-two patients were enrolled. Of the 132 patients, 44 patients were in COVID-19 group and 88 patients were in non-COVID-19 group. The average age was 67.6 years. About one-third of these patients were males. Most of these patients had hypertension and dyslipidemia. The average follow-up time was 9.3 months. Eighteen patients (40.9%) had the longest SCAF duration in the COVID-19 group, while 23 patients (26.1%) had the longest SCAF duration in the non-COVID-19 group. More patients in the COVID-19 group had the longest SCAF duration than those in non-COVID-19 group with no statistical significance (odds ratio 1.96, 95% confidence interval 0.91 to 4.21, p=0.13). Conclusion: Patients with a history of previous COVID-19 infection receiving CIEDs had no significantly increased risk of SCAF. Keywords: COVID-19; CIEDs; Subclinical atrial fibrillation; AHRE burden; Atrial high-rate episode