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. 2022 Feb;19(2):206-216.
doi: 10.1016/j.hrthm.2021.10.020. Epub 2021 Oct 26.

Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey

Oholi Tovia-Brodie  1 , Moshe Rav Acha  2 , Bernard Belhassen  3 , Alessio Gasperetti  4 , Marco Schiavone  4 , Giovanni Battista Forleo  4 , Milton E Guevara-Valdivia  5 , David Valdeolivar Ruiz  5 , Nicolas Lellouche  6 , David Hamon  6 , Davide Castagno  7 , Matteo Bellettini  7 , Gaetano M De Ferrari  7 , Mikael Laredo  8 , Jean-Baptiste Carvès  8 , Barbara Ignatiuk  9 , Giampaolo Pasquetto  9 , Paolo De Filippo  10 , Giovanni Malanchini  10 , Behzad B Pavri  11 , Craig Raphael  11 , Luigi Rivetti  12 , Roberto Mantovan  12 , Jason Chinitz  13 , Melissa Harding  13 , Giuseppe Boriani  14 , Edoardo Casali  14 , Elaine Y Wan  15 , Angelo Biviano  15 , Carlos Macias  16 , Stepan Havranek  17 , Pietro Enea Lazzerini  18 , Antonio M Canu  19 , Marco Zardini  20 , Giulio Conte  21 , Óscar Cano  22 , Michela Casella  23 , Boris Rudic  24 , Alexander Omelchenko  25 , Nilesh Mathuria  26 , Gaurav A Upadhyay  27 , Asaf Danon  28 , Arie Lorin Schwartz  29 , Philippe Maury  30 , Shiro Nakahara  31 , Gustavo Goldenberg  32 , Nicolas Schaerli  33 , Sergiy Bereza  34 , Angelo Auricchio  21 , Michael Glikson  2 , Yoav Michowitz  2
Affiliations

Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey

Oholi Tovia-Brodie et al. Heart Rhythm. 2022 Feb.

Abstract

Background: Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown.

Objective: The purpose of this study was to gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey.

Methods: Fifty-three centers from 13 countries across 4 continents provided information on 166 patients with known active COVID-19 who underwent a CIED procedure.

Results: The CIED procedure rate in 133,655 hospitalized COVID-19 patients ranged from 0 to 16.2 per 1000 patients (P <.001). Most devices were implanted due to high-degree/complete atrioventricular block (112 [67.5%]) or sick sinus syndrome (31 [18.7%]). Of the 166 patients in the study survey, the 30-day complication rate was 13.9% and the 180-day mortality rate was 9.6%. One patient had a fatal outcome as a direct result of the procedure. Differences in patient and procedural characteristics and outcomes were found between Europe and North America. An older population (76.6 vs 66 years; P <.001) with a nonsignificant higher complication rate (16.5% vs 7.7%; P = .2) was observed in Europe vs North America, whereas higher rates of critically ill patients (33.3% vs 3.3%; P <.001) and mortality (26.9% vs 5%; P = .002) were observed in North America vs Europe.

Conclusion: CIED procedure rates during known active COVID-19 disease varied greatly, from 0 to 16.2 per 1000 hospitalized COVID-19 patients worldwide. Patients with active COVID-19 infection who underwent CIED implantation had high complication and mortality rates. Operators should take these risks into consideration before proceeding with CIED implantation in active COVID-19 patients.

Keywords: Active COVID-19; Cardiac implantable electronic device procedure; Complications; Mortality; Personal protective equipment.

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Figures

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Graphical abstract
Figure 1
Figure 1
Rate of cardiac implantable electronic device (CIED) procedures per 1000 hospitalized coronavirus disease 2019 (COVID-19) patients per country. The number of centers that contributed data from each country and the number of procedures performed used for rate calculation are presented beneath the graph. The procedural rate varied significantly between 0 and 16.2 per 1000 hospitalized patients (P <.001). Of note, 6 centers that did not perform CIED implantations (see text for discussion) and 3 centers that provided data on CIED implantations (2 from Israel and 1 from the United States with 2, 1, and 5 implanted patients, respectively) could not provide data on the total number of hospitalized COVID-19 patients.
Figure 2
Figure 2
Number of cardiac implantable electronic device procedures, complications, and mortality by month and continent. The number of procedures is presented per continent, with complications in purple and mortality in red.
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization Coronavirus Disease (COVID-19) https://www.who.int/publications/m/item/weekly-epidemiological-update-on... Weekly Epidemiological Update—May 11 2021. Published May 11, 2021. Accessed May 11, 2021. Available at:
    1. Gupta A., Madhavan M.V., Sehgal K., et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26:1017–1032. - PMC - PubMed
    1. Coromilas E.J., Kochav S., Goldenthal I., et al. Worldwide survey of COVID-19-associated arrhythmias. Circ Arrhythm Electrophysiol. 2021;14 - PMC - PubMed
    1. Turagam M.K., Musikantow D., Goldman M.E., et al. Malignant arrhythmias in patients with COVID-19: incidence, mechanisms, and outcomes. Circ Arrhythm Electrophysiol. 2020;13 - PMC - PubMed
    1. Migliore F., Zorzi A., Gregori D., et al. Urgent pacemaker implantation rates in the Veneto region of Italy after the COVID-19 outbreak. Circ Arrhythm Electrophysiol. 2020;13 - PMC - PubMed

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