Key result
The 2020 COVID-19 outbreak is not associated with increased arrhythmias or mortality in ICD patients.
Why the study?
The 2020 SARS-CoV-2 outbreak reduced availability of traditional cardiology consultations, raising uncertainty about outcomes in ICD patients followed remotely during the epidemic.
Does the COVID-19 epidemic period affect the rate of arrhythmic events and mortality in ICD carriers followed by remote monitoring compared to a pre-epidemic period?
Cohort (n=691)
No
Does the COVID-19 epidemic period affect the rate of arrhythmic events and mortality in ICD carriers followed by remote monitoring compared to a pre-epidemic period?
Absolute Event Rate: 10% vs 10%
p-value: p=0.75
Remote monitoring of ICD patients during the COVID-19 pandemic was associated with similar rates of arrhythmic events and mortality compared to the pre-pandemic period, suggesting its reliability during healthcare disruptions.
Supports remote ICD monitoring reliability during disruptions; extends observational data but leaves open prospective validation.
BACKGROUND: The 2020 severe acute respiratory syndrome coronavirus 2 outbreak entailed reduced availability of traditional (in-office) cardiology consultations. Remote monitoring is an alternative way of caring that may potentially mitigate the negative effects of the epidemic to the care of cardiovascular diseases. We evaluated the outcome of implantable cardioverter defibrillator (ICD) carriers followed up remotely in 2020 (epidemic period) versus 2019 (control). METHODS: We included all patients with an ICD who remained remotely monitored from the beginning to the end of each year. The combined end point included: new-onset atrial fibrillation; sustained ventricular tachycardia >170 bpm without ICD intervention; appropriate ICD intervention (either shock or antitachycardia pacing); any-cause death. Multiple events in the same patients were counted separately if occurring ≥48 h apart. RESULTS: In 2020, 52 end points occurred in 37 of 366 (10%) ICD carriers [0.14/patient (95% confidence interval [CI] = 0.11-0.19)] versus 43 end points in 32 of 325 (10%) ICD carriers in 2019 [0.13/patient (95% CI = 0.10-0.18) P = 0.75]. There was no difference between the distribution of any individual end point in 2020 versus 2019 although a nonsignificant mortality increase was observed (from 2.8% to 4.6%, P = 0.19). The lowest weekly event rate occurred during the national lock down in spring 2020 but a similar trend occurred also in 2019 suggesting that the effect may not be linked to social distancing measures. CONCLUSIONS: We did not observe an increase in a combined end point including arrhythmic events and mortality in ICD carriers who were remotely monitored in 2020, compared to 2019, despite the negative impact of the coronavirus disease 2019 outbreak on the healthcare system.
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Zorzi et al. (2022) conducted a cohort in Implantable cardioverter defibrillator (ICD) carriers (n=691). 2020 COVID-19 outbreak period vs. 2019 period was evaluated on Combined end point of new-onset atrial fibrillation, sustained ventricular tachycardia >170 bpm without ICD intervention, appropriate ICD intervention, or any-cause death (p=0.75). The 2020 COVID-19 outbreak was not associated with an increase in arrhythmic events or mortality among remotely monitored ICD patients compared to 2019 (10% vs 10%; P=0.75).
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