{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:29:49Z","timestamp":1761845389250,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Myriad cardiovascular manifestations have been reported with COVID\u201019. We previously reported that failure of PR interval shortening with increasing heart rate (HR) in patients with COVID\u201019 is associated with adverse outcomes. Here, we report on heart rate variability (HRV) and clinical outcomes in patients with chronic atrial fibrillation (cAF) hospitalized for COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of admitted COVID\u201019 patients with cAF between 1 March 2020 to 30 June 2020 was performed. HRV in cAF was compared during pre\u2010COVID\u201019 and COVID\u201019 admissions; we selected pre\u2010COVID\u201019 ECGs with HRs that were within 10 beats per minute of the COVID\u201019 ECGs. Mean HR and each RR interval were recorded. Time\u2010domain measurements of HR variability were then calculated (SDSD, RMSSD, pNN50). Clinical outcomes during COVID\u201019 were correlated to indices of HRV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 184 ECGs (95 pre\u2010COVID\u201019, 89 COVID\u201019) from 38 cAF in\u2010patients were included. Mean age 78.6\u00a0\u00b1\u00a011.4\u00a0years, male 44.7%. The mean number of ECGs analyzed per patient pre\u2010COVID\u201019 was 2.50 and during COVID\u201019 was 2.34. Comparing pre\u2010COVID\u201019 versus COVID\u201019 ECGs showed: mean HR (95.9\u00a0\u00b1\u00a024.3 vs. 101.6\u00a0\u00b1\u00a022.8 BPM; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.10), SDSD (109.0\u00a0\u00b1\u00a050.6 vs. 90.3\u00a0\u00b1\u00a037.2\u00a0ms; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), RMSSD (184.1\u00a0\u00b1\u00a080.4 vs. 147.3\u00a0\u00b1\u00a059.8\u00a0ms; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), pNN50 (73.8\u00a0\u00b1\u00a016.3 vs. 65.6\u00a0\u00b1\u00a016.6%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01). Patients who had a smaller pNN50 during a COVID\u201019 admission had increased mortality (50.0% vs. 14.3%; log\u2010rank test <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with cAF, the HRV was reduced during COVID\u201019 compared with prior illnesses at similar average heart rates. Patients with the most depressed HRV as measured by pNN50 had an associated increase in mortality compared with patients whose HRV was preserved.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12569","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T19:12:40Z","timestamp":1623957160000},"page":"893-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Describing heart rate variability in patients with chronic atrial fibrillation during hospitalization for COVID\u201019"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9411-1478","authenticated-orcid":false,"given":"Joey","family":"Junarta","sequence":"first","affiliation":[{"name":"Department of Medicine Thomas Jefferson University Hospital Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua M.","family":"Riley","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behzad B.","family":"Pavri","sequence":"additional","affiliation":[{"name":"Department of Medicine Thomas Jefferson University Hospital Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0950"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30079-5"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1091"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23406"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.007220"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047349"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.06.009"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0b013e3181ebb152"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.22.3.315"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00429-005-0462-1"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.04.032"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.066"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv015"},{"key":"e_1_2_10_16_1","first-page":"514","article-title":"Heart 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