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Updated: Aug 11, 2025
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
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COVID-19 and atrial fibrillation: Intercepting lines
Maria Donniacuo1, Antonella De Angelis1, Concetta Rafaniello1
1Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Frontiers in Cardiovascular Medicine
|February 9, 2023
Summary
COVID-19 increases atrial fibrillation (AF) risk by altering angiotensin-converting enzyme 2 (ACE2) pathways and promoting a prothrombotic state. Certain COVID-19 drugs may also heighten arrhythmia risk.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Atrial fibrillation (AF) is common in COVID-19 patients, with nearly 20% having a history or developing new-onset AF.
- COVID-19 promotes a prothrombotic state, increasing arrhythmia susceptibility during infection and recovery.
- AF is a major cause of morbidity and mortality.
Purpose of the Study:
- To review mechanisms linking COVID-19 to AF.
- To summarize the cardiovascular safety of drugs used for COVID-19 treatment.
Main Methods:
- Literature review of COVID-19 and AF.
- Analysis of molecular mechanisms involving angiotensin-converting enzyme 2 (ACE2).
- Evaluation of drug-induced cardiac risks.
Main Results:
- SARS-CoV-2 infection disrupts atrial ACE2, increasing angiotensin II and decreasing angiotensin (1-7), leading to cardiac issues.
- Drugs like azithromycin, lopinavir/ritonavir, ibrutinib, and remdesivir may increase arrhythmia risk.
Conclusions:
- COVID-19-related AF involves ACE2 pathway disruption and prothrombotic changes.
- Careful monitoring of cardiac safety is essential when using certain COVID-19 medications.
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