Abstract Body (Do not enter title and authors here): Background: New onset AF during acute illness has a high rate of AF recurrence within 5-yr. However, little is known about AF progression in patients with new onset AF during COVID illness. It is also unknown whether the time of COVID diagnosis (early vs late) impacts AF progression. More specifically, did the potentially different immune and inflammatory responses during early vs late COVID produce structural and electrical cardiac remodeling that would increase the likelihood of AF progression.
Objective: We sought to compare AF progression in patients with new onset AF during early vs late COVID and hypothesized that early COVID was associated with increased AF progression compared to late COVID.
Methods: From Apr 2020 to Feb 2024, patients receiving a SARS-2-CoV test without a history of AF with new onset AF and at least 3-mo of follow up were included (N=11,767). Patients were subdivided based on pos vs neg SARS-2-CoV test and time of diagnosis. Early COVID diagnosis (n=3052) included Apr 2020-Aug 2021 and late COVID (n=8715) included Sep 2021-Feb 2024. AF progression endpoints at 3-, 6- and 12-mo included AF hospitalization, AF emergency department (ED) visit, cardioversion and AF ablation.
Results: Patients with late COVID were more likely females with hypertension, coronary artery disease and hyperlipidemia compared to early COVID patients. At 3- and 6-mo follow-up there was no difference in AF progression between the early and late COVID groups for any endpoint. In contrast, at 12-mo follow up there was in increase in late diagnosis group AF ED visits (11% vs 7.6%, p<0.0001) and a trend toward more AF hospitalizations (6.3% vs 4.1%, p=0.07). There was no difference in cardioversions or AF ablations between the groups at 12-mo. Finally, patients with an early COVID trended to be less likely to undergo AF ablation (3.9% vs 5.6%, p=0.14) and have an AF hospitalization (4.1% vs 6.3%, p=0.06) at 12-mo than new onset AF patients during the same time without COVID. There was no difference in AF progression between COVID pos and neg patients in the late COVID group.
Conclusions: These findings demonstrate that there is no significant difference in AF progression in patients with new onset AF during COVID when stratified by timing of diagnosis. As such, our data do not support the hypothesis that early COVID resulted in more significant structural or electrical cardiac remodeling that would increase the likelihood of AF progression.