Effects of COVID‐19 lockdown on arrhythmias in patients with implantable cardioverter‐defibrillators in southern Italy

Abstract

Background:The effects of lockdown on non-COVID patients are varied and unexpected. The aim is to evaluate the burden of cardiac arrhythmias during a lockdown period because of COVID-19 pandemics in a population implanted with cardiac defibrillators and followed by remote monitoring. Methods:In this retrospective, multicentre cohort study, we included 574 remotely monitored implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy-defibrillator (CRT-D) recipients implanted before January 1, 2019, at seven hospitals in the Campania region, comparing the burden of arrhythmias occurred during the lockdown period because of COVID-19 epidemics (from March 9 to May 1, 2020) with the arrhythmias burden of the corresponding period in 2019 (reference period). Data collection was performed through remote monitoring.Results: During the lockdown period, we observed ventricular tachyarrhythmias (ventricular tachycardia or fibrillation) in 25 (4.8%) patients while in seasonal reference period we documented ventricular tachyarrhythmias in 12 (2.3%) patients; the comparison between the periods is statistically significant (P < .04). Atrial arrhythmias were detected in 38 (8.2%) subjects during the lockdown period and in 24 (5.2%) during the reference period (P < .004). Conclusion:In seven hospitals in the Campania region, during the pandemic lockdown period, we observed a higher burden of arrhythmic events in ICD/CRT-D patients through device remote monitoring.

Implantable-cardioverter defibrillators and COVID-19: A complicated relationship

“…In studies from 3 separate regions in Italy, Malanchini et al [3], Sassone et al [4], and Zorzi et al [5] reported no change in ventricular arrhythmia burden and ICD therapies during the COVID-19 pandemic, disputing a higher incidence of cardiac arrests in the same period in Italy. However, Ducceschi et al [6] reported an increase in both ventricular and atrial tachyarrhythmias during the pandemic in the Campania region of Italy. In Germany, Hauck et al [7] reported no change in cardiac arrhythmias in ICD patients enrolled in a clinic, but Rath et al [8] reported an increase in cardiac arrhythmias in ICD patients during the second wave of the COVID-19 pandemic.…”