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Case Reports
. 2022 Aug;18(8):621-626.
doi: 10.2217/fca-2021-0055. Epub 2022 Jun 23.

Cardiac resynchronization therapy defibrillator: a de novo implant in a COVID-19 patient by an echo-guided axillary venous approach

Aldo Agea  1 , Maria C Bellino  1 , Domenico Gianfrancesco  2 , Francesco Palma  1 , Giuseppe A Carpagnano  1 , Rita Mr Torraco  1 , Maria M Marino  1 , Paola Persichella  1 , Sebastiano Zingaro  1 , Fabio Siena  1 , Roberto Di Tullio  1 , Giovanni Deluca  1
Affiliations
Case Reports

Cardiac resynchronization therapy defibrillator: a de novo implant in a COVID-19 patient by an echo-guided axillary venous approach

Aldo Agea et al. Future Cardiol. 2022 Aug.

Abstract

The COVID-19 pandemic has seriously revolutionized the management of patients who need an implanted cardiac implantable electronic device. We report, for the first time, a successful cardiac resynchronization therapy defibrillator implantation procedure in an 82-year-old man affected by COVID-19, recent myocardial infarction, second-degree 2:1 atrioventricular block and left bundle branch block.

Keywords: COVID-19; TYRX; atrioventricular block; cardiac resynchronization therapy; defibrillators; device implantation; echo-guided venous approach; infection; myocardial infarction.

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Figures

Figure 1.
Figure 1.. Twelve-lead ECG revealed sinus rhythm, second-degree 2:1 atrioventricular block with ventricular rate at 40 beats/min and left bundle branch block.
Figure 2.
Figure 2.. Bedside chest x-ray showing the cardiac resynchronization therapy defibrillator (Biotronik Rivacor 7 HF).
Figure 3.
Figure 3.. The needle inside the left axillary vein.
Figure 4.
Figure 4.. Pre-discharge ECG showing paced rhythm in dual-chamber pacing mode at 60 beats/min.
In this figure, it is possible to appreciate the minor QRS duration compared with the pre-treatment ECG.
See this image and copyright information in PMC

References

    1. Tsai PH, Lai WY, Lin YY et al. Clinical manifestation and disease progression in COVID-19 infection. J Chin Med Assoc. 84(1), 3–8 (2021). - PubMed
    1. Bechlioulis A, Sfairopoulos D, Korantzopoulos P et al. Impact of COVID-19 pandemic on cardiac electronic device implantations in Northwestern Greece. Am J Cardiovasc Dis. 11(4), 489–493 (2021). - PMC - PubMed
    1. Zareba W, Klein H, Cygankiewicz I et al. Effectiveness of cardiac resynchronization therapy by QRS morphology in the Multicenter Automatic Defibrillator Implantation Trial – Cardiac Resynchronization Therapy (MADIT-CRT). Circulation 123(10), 1061–1072 (2011). - PubMed
    1. Deluca G, Massari VFM, Musaico F et al. Ultrasound-guided venipuncture for implantation of cardiac im-plantable electronic devices: a single-center, retrospective study. Pacing Clin. Electrophysiol. 43, 713–719 (2020). - PubMed

    2. • Study concerning the echo-guided approach used in our case report, which explains why it is a safe and effective method for subclavian puncture.

    1. European Society for Cardiology. ESC guidance for the diagnosis and management of CV disease during the COVID-19 pandemic (2020). www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance

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