Ventricular arrhythmias among patients with implantable cardioverter
defibrillator during the COVID-19 epidemic: Insights from the Italian
frontline
Abstract
Background— According to published evidence, Coronavirus Disease‐2019
(COVID‐19) is associated with myocardial injury and could lead to higher
risk of arrhythmic complications. However, there is a substantial lack
of wide population data on the arrhythmogenic effect of the disease.
Objective—to describe the effect of COVID-19 epidemic on arrhythmic
burden among high risk patients Methods— This cross-sectional
comparative study describes the incidence of ventricular arrhythmia (VA)
during the epidemic outbreak (study period) and compares it to the same
timeframe in 2019 (reference period). Inclusion criteria were age
(>18 years) and having an implantable cardiac defibrillator
(ICD). Results – Among 455 patients (mean age 64.9 ± 15.7 years),
25.1% were females and 39.6% had a CRTD. In the study period, 45
(9.9%) patients experienced a total of 86 VA; 8 patients (1.7%)
required anti-tachycardia-pacing (ATP) and 6 (1.3%) at least one shock.
In the reference period, a total of 69 events occurred in 36 patients
(7.9%). 6 patients (1.3%) required ATP and 3 (0.7%) at least one
shock. The number of patients that suffered from any arrhythmic events
in the study period (9.9 vs 7.9%) did not significantly differ from the
reference period (χ2 = 1.09, p = 0.29). The main predictor of VA during
COVID-19 epidemic was previous history of any ICD therapy (OR = 3.84, p
< 0.001). Conclusions – No evidence of increase of arrhythmic
burden was found during COVID-19 epidemic. The present study contributes
to illustrate the impact of the COVID-19 on the cardiovascular system.