Sinusoidal Atrial Fibrillation (Yasser’s Fibrillation) and Partial SAN Function in COVID-19 Pneumonia; a New Cardiovascular Discovery Change in Atrial Fibrillation Directory

Introduction: Atrial fibrillation (AF) is one of the most common and probable serious arrhythmias and a hallmark of an increasing risk of pathological thrombus formation. Interestingly, normal sinus rhythm (NSR) is the standard rhythm in a normal person. The sino-atrial node (SAN) is the heart's pacemaker and generator of the normal electrical conduction system of the heart which allows for the generating of electrical impulses. In AF, the normal regular electrical impulses generated by the sinoatrial node are overwhelmed by disorganized electrical waves, usually originating from the roots of the pulmonary veins. These disorganized waves conduct intermittently through the atrioventricular node (AVN) leading to irregular activation of the ventricles that generate the heartbeat. Cases presentation: Four different cases were described. 1. An elderly female patient presented to the ICU with metastatic complicated Mantle cell lymphoma, COVID-19 pneumonia, and irregular heart rate. 2. A senile male patient presented to the intensive care unit (ICU) with an aortic aneurysm, COVID-19 pneumonia, consumptive thrombocytopenia, lung fibrosis, and irregular heart rate. 3. A middle-aged female presented to the ICU with chronic renal failure (CRF) on regular hemodialysis, liver cell failure (LCF), pseudo-orange abdominal cellulitis, valvular heart replacement, and irregular heart rate. 4. An elderly female patient presented with cardiomyopathy, global cardiomegaly, irregular heart rate, diabetes, pseudo-orange abdominal cellulitis, liver cirrhosis, and COVID-19 pneumonia. Method of study and patients: Retrospective-Observational four case report series study was conducted in Kafr El-Bateekh Central Hospital staring from January 21, 2023 and ending on June 24, 2024 on COVID-19 pneumonia and atrial fibrillations. Conclusion: Sinusoidal atrial fibrillations (Yasser’s fibrillation) or mixed AF are a new cardiovascular discovery. The partial sino-atrial nodal function has essential role in the presence of Sinusoidal atrial fibrillations (Yasser’s fibrillation) or mixed AF and its interpretation. Sinusoidal atrial fibrillations (Yasser’s fibrillation) or mixed AF may be balanced between AF and normal sinus rhythm. The percentages of normal sinus beats to AF beats in the cases of Sinusoidal atrial fibrillations (Yasser’s fibrillation) may be a guide for approximate healthy or sick part of the sinoatrial node. Widening the research for the Sinusoidal atrial fibrillations (Yasser’s fibrillation) or mixed AF will be recommended.