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. 2022 Jan 12;11(1):120.
doi: 10.3390/biology11010120.

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Matteo Ziacchi  1 , Leonardo Calò  2 , Antonio D'Onofrio  3 , Michele Manzo  4 , Antonio Dello Russo  5 , Luca Santini  6 , Giovanna Giubilato  7 , Cosimo Carriere  8 , Vincenzo Ezio Santobuono  9 , Gianluca Savarese  10 , Carmelo La Greca  11 , Giuseppe Arena  12 , Antonello Talarico  13 , Ennio Pisanò  14 , Massimo Giammaria  15 , Antonio Pangallo  16 , Monica Campari  17 , Sergio Valsecchi  17 , Igor Diemberger  1
Affiliations

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Matteo Ziacchi et al. Biology (Basel). .

Abstract

Aims: The utilization of remote monitoring platforms was recommended amidst the COVID-19 pandemic. The HeartLogic index combines multiple implantable cardioverter defibrillator (ICD) sensors and has proved to be a predictor of impending heart failure (HF) decompensation. We examined how multiple ICD sensors behave in the periods of anticipated restrictions pertaining to physical activity.

Methods: The HeartLogic feature was active in 349 ICD and cardiac resynchronization therapy ICD patients at 20 Italian centers. The period from 1 January to 19 July 2020, was divided into three phases: pre-lockdown (weeks 1-11), lockdown (weeks 12-20), post-lockdown (weeks 21-29).

Results: Immediately after the implementation of stay-at-home orders (week 12), we observed a significant drop in median activity level whereas there was no difference in the other contributing parameters. The median composite HeartLogic index increased at the end of the Lockdown. The weekly rate of alerts was significantly higher during the lockdown (1.56 alerts/week/100 pts, 95%CI: 1.15-2.06; IRR = 1.71, p = 0.014) and post-lockdown (1.37 alerts/week/100 pts, 95%CI: 0.99-1.84; IRR = 1.50, p = 0.072) than that reported in pre-lockdown (0.91 alerts/week/100 pts, 95%CI: 0.64-1.27). However, the median duration of alert state and the maximum index value did not change among phases, as well as the proportion of alerts followed by clinical actions at the centers and the proportion of alerts fully managed remotely.

Conclusions: During the lockdown, the system detected a significant drop in the median activity level and generated a higher rate of alerts suggestive of worsening of the HF status.

Keywords: CRT; ICD; heart failure; multisensor; remote monitoring.

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Conflict of interest statement

M. Ziacchi has received speaker fees from Abbott, Biotronik, Boston Scientific, Medtronic; I. Diemberger has received minor speaker fees from Boston Scientific, Medtronic and Biotronik; M. Campari and S. Valsecchi are employees of Boston Scientific. The other authors report no conflict.

Figures

Figure 1
Figure 1
Weekly averages (with standard deviation) of the HeartLogic combined index and all physiologic parameters collected by the devices from 1 January to 19 July. The period was divided in 3 phases: pre-lockdown (weeks 1–11), lockdown (weeks 12–20), post-lockdown (weeks 21–29). S1: First heart sound; S3: Third heart sound; *: p < 0.05 versus pre-lockdown average.
Figure 2
Figure 2
Comparison of trends collected immediately before and after the alerts among study phases. Weekly averages (with standard deviation) of HeartLogic index and all physiologic parameters are reported from 5 weeks before to 5 weeks after the alert onset (week 0). S1: First heart sound; S3: Third heart sound; *: p < 0.05 post-lockdown versus pre-lockdown; #: p < 0.05 post-lockdown versus lockdown.
See this image and copyright information in PMC

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