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Multicenter Study
. 2020 Nov;15(8):1445-1456.
doi: 10.1007/s11739-020-02487-w. Epub 2020 Sep 5.

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Giuseppe Boriani  1 , Pietro Palmisano  2 , Federico Guerra  3 , Matteo Bertini  4 , Gabriele Zanotto  5 , Carlo Lavalle  6 , Pasquale Notarstefano  7 , Michele Accogli  2 , Giovanni Bisignani  8 , Giovanni Battista Forleo  9 , Maurizio Landolina  10 , Antonio D'Onofrio  11 , Renato Ricci  12 , Roberto De Ponti  13 ; AIAC Ricerca Network Investigators
Collaborators, Affiliations
Multicenter Study

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Giuseppe Boriani et al. Intern Emerg Med. 2020 Nov.

Abstract

COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March-April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy.

Keywords: Ablation; Arrhythmia; Atrial fibrillation; COVID-19; Emergency; Implantable cardioverter defibrillators; Pacemakers; Remote monitoring.

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Conflict of interest statement

GB: small speaker fee from Medtronic, Boston, Biotronik, Boehringer Ingelheim and Bayer. PP: small speaker fee from Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Medtronic. Novartis and personal fees from Proctorship agreement with Abbott, Medtronic, Biotronik, and Boston Scientific. MB: small speaker fee from Boston Scientific, Abbott, Boehringer Ingelheim and Bayer. ML: modest speaker fee from Bayer, Boehringer Ingelheim, Boston Scientific, LivaNova, Medtronic, and Pfizer. RPR: small speaker fees by Boston e Biotronik; advisory board modest fees by Dompé. RDP: lecture fees from Biosense Webster and Biotronik. No conflict of interest reported by the other authors.

Figures

Fig. 1
Fig. 1
Incidence of COVID-19 cases in Italian regions (a). Geographic distribution of the centres that responded to the survey across Italy (b). Number of operators per centre (c). CIED implantation volume of participating centres (d). Ablation procedures volume of participating centres (e). *Data from Italian Civil Protection Department [3]. CIED cardiac implantable electronic device
Fig. 2
Fig. 2
Variations in the number of procedures reported by participating centres during the two months March–April 2020 compared to two months March–April 2019: elective pacemaker implantations (a); elective ICD implantations for primary prevention and for secondary prevention (b); elective ablations (c); CIEDs implantations in emergency setting (d); ablations performed in emergency setting (e); cases requiring acute treatment of AF in emergency setting (f). AF atrial fibrillation, CIEDs cardiac implantable electronic devices, ICD implantable cardioverter-defibrillator
Fig. 3
Fig. 3
Variations in the number of CIED patients followed by remote monitoring during the two months March–April 2020 compared to 2 months March–April 2019 (a). Management of in-office evaluation in CIED patients followed by remote monitoring during COVID-19 pandemic (b). CIED cardiac implantable electronic device
Fig. 4
Fig. 4
Procedures that could be performed under day-case admission (a), and under ordinary admission with a single night stay (b). CIED cardiac implantable electronic device, ICD implantable cardioverter-defibrillator, PM pacemaker, SVT supraventricular tachycardia
See this image and copyright information in PMC

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