The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department

Łukasz Bilaszewski, Wojciech Timler, Katarzyna Budrewicz, Michał Marczak, Remigiusz Kozłowski, Joanna Wizowska, Małgorzata Timler, Dariusz Jagielski, Michał Dudek, Paweł Rasmus, Dorota Zyśko and Dariusz Timler
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Łukasz Bilaszewski: Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Wojciech Timler: Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 92-212 Lodz, Poland
Katarzyna Budrewicz: Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Michał Marczak: Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
Remigiusz Kozłowski: Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
Joanna Wizowska: Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Małgorzata Timler: Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
Dariusz Jagielski: Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland
Michał Dudek: Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, 90-153 Lodz, Poland
Paweł Rasmus: Department of Medical Psychology, Medical University of Lodz, 90-131 Lodz, Poland
Dorota Zyśko: Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Dariusz Timler: Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 92-212 Lodz, Poland

IJERPH, 2021, vol. 18, issue 11, 1-8

Abstract: Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. Materials and Methods: A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July–December 2019 (pre-pandemic period) versus July–December 2020 (pandemic period) was performed. Results: During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/?13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5–30 h) during the pandemic period vs. 5 h (3–24 h) during the non-pandemic period ( p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital ( p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. Conclusions: 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode.

Keywords: atrial fibrillation; cardioversion; emergency department; COVID-19; pandemic (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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