Case Reports of Implantable Cardiac Device Physiologic Sensor Changes in Subjects with Coronavirus Disease-2019 Infection

Abstract

The severe acute respiratory syndrome novel coronavirus-2 pandemic has established a new set of challenges to health care delivery. Remotely monitored physiologic sensors on implantable cardiac devices can provide insight into the differential diagnosis of dyspnea in the heart failure population. We report on a unique pattern of sensor deviations that seem to occur specifically with severe acute respiratory syndrome novel coronavirus-2 infection.

Fig. 1

Case 1. HeartLogic tracings depicting a sharp increase in respiratory rate, RSBI, nighttime heart rate, S1, S3, temperature and thoracic impedance with onset of severe acute respiratory syndrome novel coronavirus-2 symptoms (purple vertical line). Major symptom resolution (green vertical line) was associated with recovering sensor trends. Maximum and minimum values are indicated with red dots. A baseline was calculated for each sensor trend (tan shaded interval). RSBI, rapid shallow breathing index.

Fig. 2

Case 2. HeartLogic sensor tracings demonstrating trends with infection of severe acute respiratory syndrome novel coronavirus-2 (SARS-CoV-2). The onset of viral symptoms, including anosmia, is indicated by the purple vertical line. Two weeks after the initial symptoms, the patient presented with shortness of breath, testing positive for SARS-CoV-2 infection (red vertical line). A rapid increase in the respiratory rate, nighttime heart rate, S1, temperature, and thoracic impedance with a decrease in S3 and activity level were noted before the date of admission. Major symptom recovery is noted by the green vertical line. A baseline was calculated for each sensor trend (tan shaded interval). Maximum and minimum values are indicated with red dots. RSBI, rapid shallow breathing index.

Fig. 3

Case 3. HeartLogic sensor trends from a long-term care facility resident who was asymptomatic at the time of severe acute respiratory syndrome novel coronavirus-2 testing (red vertical line). A steep increase in respiratory rate, RSBI, nighttime heart rate, S1, temperature, and thoracic impedance and a decrease in S3 and activity level were noted with infection. Major symptom recovery (green vertical line) was associated with recovery of sensor trends. A baseline was calculated for each sensor trend (tan shaded interval). Maximum and minimum values are indicated with red dots. RSBI, rapid shallow breathing index.