Impact of COVID-19 on the incidence of cardiac arrhythmias in implantable cardioverter defibrillator recipients followed by remote monitoring

Abstract

Background: The coronavirus disease 2019 (COVID-19) has been a fast-growing worldwide pandemic. Aims: We aimed to investigate the incidence of cardiac arrhythmias among a large French cohort of implantable cardioverter defibrillator recipients over the first 5 months of 2020. Methods: 5954 implantable cardioverter defibrillator recipients were followed by remote monitoring during the COVID-19 period (from 01 January to 31 May 2020). Data were obtained from automated remote follow-up of implantable cardioverter defibrillators utilizing the Implicity® platform. For all patients, the type of arrhythmia (atrial fibrillation, ventricular tachycardia or ventricular fibrillation), the number of ventricular arrhythmia episodes and the type of implantable cardioverter defibrillator-delivered therapy were recorded. Results: A total of 472 (7.9%) patients presented 4917 ventricular arrhythmia events. An increase in ventricular arrhythmia incidence was observed after the first COVID-19 case in France, and especially during weeks #10 and #11, at the time of major governmental measures, with an increase in the incidence of antitachycardia pacing delivered therapy. During the 11 weeks before the lockdown order, the curve of the percentage of live-stream television coverage of COVID-19 information matched the ventricular arrhythmia incidence. During the lockdown, the incidence of ventricular arrhythmia decreased significantly compared with baseline (0.05 ± 0.7 vs 0.09 ± 1.2 episodes per patient per week, respectively; P < 0.001). Importantly, no correlation was observed between ventricular arrhythmia incidence and the curve of COVID-19 incidence. No changes were observed regarding atrial fibrillation/atrial tachycardia episodes over time. Conclusions: An increase in ventricular arrhythmia incidence was observed in the 2 weeks before the lockdown order, at the time of major governmental measures. Ventricular arrhythmia incidence decreased dramatically during the lockdown.

Physical Activity in Patients With Heart Failure During and After COVID-19 Lockdown: Single-Center Observational Retrospective Study

“…We acknowledge that the study enrolled a very selected group of patients to carefully investigate a specific feature (ie, PA) in the three considered periods. Thus, results requiring larger samples to be demonstrated could not be found, as in the case of ventricular arrhythmias whose highest incidence was a mean of 0.09 (SD 1.2) episodes per patient per week in a previous study on the COVID-19 pandemic and remote monitoring [ 21 ].…”

One-Year Recording of Cardiac Arrhythmias in a Non-Infected Population with Cardiac Implantable Devices During the COVID-19 Pandemic

“…We did not find any increased incidence of ventricular arrhythmias during the COVID-19 pandemic in non-infected patients, consistent with previous studies on the topic. 4–6 , 17 However, we found that, during the COVID-19 pandemic, the incidence of AF was higher than during the pre-COVID-19 period. Among the previous four studies on this topic, only one study from France mentioned atrial arrhythmia (the others only investigated ventricular arrhythmia burden); the authors demonstrated no changes regarding the evolution of atrial fibrillation/tachycardia episodes during the COVID-19 pandemic.…”

“…Among the previous four studies on this topic, only one study from France mentioned atrial arrhythmia (the others only investigated ventricular arrhythmia burden); the authors demonstrated no changes regarding the evolution of atrial fibrillation/tachycardia episodes during the COVID-19 pandemic. 17 The most likely explanation for the observed discrepancy was that the authors only studied the evolution of the incidence of atrial fibrillation/tachycardia episodes during the epidemic period and did not compare it with the pre-COVID-19 period. Additionally, we found a sudden increase in daily NSVT duration after the first COVID-19 case in Wenzhou, China, was declared and a significant drop after the final case recovered on 16 March 2020.…”

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

“…Since the association between asymptomatic viral infection and arrhythmia risk has not been clearly established, as suggested by few published studies, 15,22 and although none of the studied patients was hospitalized for COVID‐19 infection or respiratory illness, we are not able to exclude that asymptomatic COVID infections may have influenced our results.…”

“…Another important study that needs to be considered is published by Galand et al 22 on a very large cohort of patients with ICD and CRTD in France. In this study, an increase in VA was observed after the first Covid case and especially during the 2 weeks before lockdown at the time of major government measures; then, after the lockdown order, the incidence of VA dropped significantly.…”