tetano
Editor, Senior Moderator
Eur Heart J
. 2020 Dec 16;ehaa893.
doi: 10.1093/eurheartj/ehaa893. Online ahead of print.
Ventricular arrhythmia burden during the coronavirus disease 2019 (COVID-19) pandemic
Catherine J O'Shea[SUP] 1 2 [/SUP], Gijo Thomas[SUP] 1 [/SUP], Melissa E Middeldorp[SUP] 1 2 [/SUP], Curtis Harper[SUP] 3 [/SUP], Adrian D Elliott[SUP] 1 [/SUP], Noemi Ray[SUP] 3 [/SUP], Dennis H Lau[SUP] 1 2 [/SUP], Kevin Campbell[SUP] 1 3 [/SUP], Prashanthan Sanders[SUP] 1 2 [/SUP]
Affiliations
Abstract
Aims: Our objective was to determine the ventricular arrhythmia burden in implantable cardioverter-defibrillator (ICD) patients during COVID-19.
Methods and results: In this multicentre, observational, cohort study over a 100-day period during the COVID-19 pandemic in the USA, we assessed ventricular arrhythmias in ICD patients from 20 centres in 13 states, via remote monitoring. Comparison was via a 100-day control period (late 2019) and seasonal control period (early 2019). The primary outcome was the impact of COVID-19 on ventricular arrhythmia burden. The secondary outcome was correlation with COVID-19 incidence. During the COVID-19 period, 5963 ICD patients underwent remote monitoring, with 16 942 episodes of treated ventricular arrhythmias (2.8 events per 100 patient-days). Ventricular arrhythmia burden progressively declined during COVID-19 (P < 0.001). The proportion of patients with ventricular arrhythmias amongst the high COVID-19 incidence states was significantly reduced compared with those in low incidence states [odds ratio 0.61, 95% confidence interval (CI) 0.54-0.69, P < 0.001]. Comparing patients remotely monitored during both COVID-19 and control periods (n = 2458), significantly fewer ventricular arrhythmias occurred during COVID-19 [incident rate ratio (IRR) 0.68, 95% CI 0.58-0.79, P < 0.001]. This difference persisted when comparing the 1719 patients monitored during both the COVID-19 and seasonal control periods (IRR 0.69, 95% CI 0.56-0.85, P < 0.001).
Conclusions: During COVID-19, there was a 32% reduction in ventricular arrhythmias needing device therapies, coinciding with measures of social isolation. There was a 39% reduction in the proportion of patients with ventricular arrhythmias in states with higher COVID-19 incidence. These findings highlight the potential role of real-life stressors in ventricular arrhythmia burden in individuals with ICDs.
Trial registration: Australian New Zealand Clinical Trial Registry; URL: https://www.anzctr.org.au/; Unique Identifier: ACTRN12620000641998.
Keywords: COVID-19; Implantable cardioverter-defibrillator; Remote monitoring; Ventricular arrhythmia; Ventricular fibrillation; Ventricular tachycardia.
. 2020 Dec 16;ehaa893.
doi: 10.1093/eurheartj/ehaa893. Online ahead of print.
Ventricular arrhythmia burden during the coronavirus disease 2019 (COVID-19) pandemic
Catherine J O'Shea[SUP] 1 2 [/SUP], Gijo Thomas[SUP] 1 [/SUP], Melissa E Middeldorp[SUP] 1 2 [/SUP], Curtis Harper[SUP] 3 [/SUP], Adrian D Elliott[SUP] 1 [/SUP], Noemi Ray[SUP] 3 [/SUP], Dennis H Lau[SUP] 1 2 [/SUP], Kevin Campbell[SUP] 1 3 [/SUP], Prashanthan Sanders[SUP] 1 2 [/SUP]
Affiliations
- PMID: 33321517
- DOI: 10.1093/eurheartj/ehaa893
Abstract
Aims: Our objective was to determine the ventricular arrhythmia burden in implantable cardioverter-defibrillator (ICD) patients during COVID-19.
Methods and results: In this multicentre, observational, cohort study over a 100-day period during the COVID-19 pandemic in the USA, we assessed ventricular arrhythmias in ICD patients from 20 centres in 13 states, via remote monitoring. Comparison was via a 100-day control period (late 2019) and seasonal control period (early 2019). The primary outcome was the impact of COVID-19 on ventricular arrhythmia burden. The secondary outcome was correlation with COVID-19 incidence. During the COVID-19 period, 5963 ICD patients underwent remote monitoring, with 16 942 episodes of treated ventricular arrhythmias (2.8 events per 100 patient-days). Ventricular arrhythmia burden progressively declined during COVID-19 (P < 0.001). The proportion of patients with ventricular arrhythmias amongst the high COVID-19 incidence states was significantly reduced compared with those in low incidence states [odds ratio 0.61, 95% confidence interval (CI) 0.54-0.69, P < 0.001]. Comparing patients remotely monitored during both COVID-19 and control periods (n = 2458), significantly fewer ventricular arrhythmias occurred during COVID-19 [incident rate ratio (IRR) 0.68, 95% CI 0.58-0.79, P < 0.001]. This difference persisted when comparing the 1719 patients monitored during both the COVID-19 and seasonal control periods (IRR 0.69, 95% CI 0.56-0.85, P < 0.001).
Conclusions: During COVID-19, there was a 32% reduction in ventricular arrhythmias needing device therapies, coinciding with measures of social isolation. There was a 39% reduction in the proportion of patients with ventricular arrhythmias in states with higher COVID-19 incidence. These findings highlight the potential role of real-life stressors in ventricular arrhythmia burden in individuals with ICDs.
Trial registration: Australian New Zealand Clinical Trial Registry; URL: https://www.anzctr.org.au/; Unique Identifier: ACTRN12620000641998.
Keywords: COVID-19; Implantable cardioverter-defibrillator; Remote monitoring; Ventricular arrhythmia; Ventricular fibrillation; Ventricular tachycardia.