Antiarrhythmic therapy for atrial fibrillation in patients with the novel SARS-CoV-2 coronavirus infection: how to make the right choice?


A.I. Tarzimanova, E.E. Bykova

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
The novel SARS-CoV-2 coronavirus infection (COVID-19) has become one of the global problems of the modern world community. An analysis of the factors associated with the severe course and poor prognosis of COVID-19 indicates an important role for comorbid pathology. Cardiac arrhythmias are one of the most common cardiovascular complications of coronavirus infection, and both supraventricular and ventricular arrhythmias can be diagnosed on an ECG. The most common arrhythmia in COVID-19 is atrial fibrillation (AF); in some patients, newly diagnosed AF cases occur during the acute course of coronavirus infection or in the first months after hospital discharge. It has been shown that the prevalence of AF among patients with coronavirus infection is approximately 2 times higher than in the general population, and reaches 8%. The onset of AF leads to an increase in thromboembolic complications and worsens the prognosis of patients with COVID-19. At the same time, the severity of coronavirus infection directly affects the incidence of AF. The administration of anticoagulant therapy is one of the most important directions in the treatment of patients with novel SARS-CoV-2 coronavirus infection. Anticoagulant therapy is indicated for all COVID-19 patients with newly diagnosed AF or a history of AF without exception. The drugs of IC and III classes are recommended to restore sinus rhythm in AF paroxysm in patients with stable hemodynamics. The choice of an antiarrhythmic drug for the relief and prevention of AF in patients with SARS-CoV-2 coronavirus infection should be based on an assessment of the severity of damage to the cardiovascular system.

About the Autors

Corresponding author: Aida I. Tarzimanova, Dr. Sci. (Med.), Professor at the Department of Faculty Therapy № 2, Sechenov University, Moscow, Russia;

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