Key result
The COVID-19 outbreak was associated with a lower incidence rate of urgent pacemaker implants compared to the intra-year control period (IRR 0.81; 95% CI 0.67-0.99; P=0.040).
Why the study?
The COVID-19 outbreak was associated with lower hospitalization rates for ACS, prompting investigation into whether a similar pattern occurred for urgent pacemaker implant admissions.
Does the COVID-19 outbreak reduce admissions for urgent pacemaker implants in patients with bradyarrhythmias?
Observational (n=1,315)
Yes
Does the COVID-19 outbreak reduce admissions for urgent pacemaker implants in patients with bradyarrhythmias?
Relative Risk: 0.81 (95% CI 0.67–0.99)
Absolute Event Rate: 5% vs 6%
p-value: p=0.040
The COVID-19 outbreak and subsequent national lockdown were associated with a significant reduction in hospital admissions for urgent and elective pacemaker implants in Northern Italy, particularly among rural residents.
May signal missed bradyarrhythmia care during outbreaks; leaves open whether incidence fell or access barriers drove the drop.
AIMS: The coronavirus disease-19 (COVID-19) outbreak has been recently associated with lower hospitalization rates for acute coronary syndromes. Aim of the study was to investigate whether a similar behaviour is observed in admissions for urgent pacemaker implant. METHODS: This retrospective study included 1315 patients from 18 hospitals in Northern Italy with a high number of COVID-19 cases. Hospitalization rates for urgent pacemaker implant were compared between the following periods: 20 February to 20 April 2020 (case period); from 1 January to 19 February 2020 (intra-year control period); from 20 February to 20 April 2019 (inter-year control period). RESULTS: The incidence rate of urgent implants was 5.0/day in the case period, 6.0/day in the intra-year control period and 5.8/day in the inter-year control period. Incidence rate in the case period was significantly lower than both the intra-year [incidence rate ratio (IRR): 0.81, 95% CI 0.67-0.99, P = 0.040] and inter-year control periods (IRR: 0.79, 95% CI 0.66-0.95, P = 0.012); this reduction was highest after the national lockdown (IRR 0.68, 95% CI 0.52-0.91, P = 0.009). The prevalence of residents in rural areas undergoing urgent pacemaker implant was lower in the case period (36%) than in both the intra-year (47%, P = 0.03) and inter-year control periods (51%, P = 0.002). Elective pacemaker implants also decreased in the case period, with the incidence rate here being 3.5/day vs. 6.4/day in the intra-year (-45%) and 6.9/day in the inter-year period (-49%). CONCLUSION: Despite severe clinical patterns, the COVID-19 outbreak has negatively affected the population presentation to Emergency Departments for bradyarrhythmias requiring urgent pacemaker implant in Northern Italy. This mainly occurred after the national lockdown and concerned patients living in rural areas.
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A 2021 study conducted an observational in Bradyarrhythmias requiring urgent pacemaker implant (n=1,315). COVID-19 outbreak period vs. Intra-year and inter-year control periods was evaluated on Incidence rate of urgent pacemaker implants (IRR 0.81, 95% CI 0.67-0.99, p=0.040). The COVID-19 outbreak was associated with a lower incidence rate of urgent pacemaker implants compared to the intra-year control period (IRR 0.81; 95% CI 0.67-0.99; P=0.040).
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