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Ventricular arrhythmia burden during the coronavirus disease 2019 (COVID-19) pandemic

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dc.contributor.authorO’Shea, C.J.
dc.contributor.authorThomas, G.
dc.contributor.authorMiddeldorp, M.E.
dc.contributor.authorHarper, C.
dc.contributor.authorElliott, A.D.
dc.contributor.authorRay, N.
dc.contributor.authorLau, D.H.
dc.contributor.authorCampbell, K.
dc.contributor.authorSanders, P.
dc.date.issued2021
dc.description.abstractAims: Our objective was to determine the ventricular arrhythmia burden in implantable cardioverter-defibrillator (ICD) patients during COVID-19. Methods and results: In this multicentre, observational, cohort study over a 100-day period during the COVID-19 pandemic in the USA, we assessed ventricular arrhythmias in ICD patients from 20 centres in 13 states, via remote monitoring. Comparison was via a 100-day control period (late 2019) and seasonal control period (early 2019). The primary outcome was the impact of COVID-19 on ventricular arrhythmia burden. The secondary outcome was correlation with COVID-19 incidence. During the COVID-19 period, 5963 ICD patients underwent remote monitoring, with 16 942 episodes of treated ventricular arrhythmias (2.8 events per 100 patient-days). Ventricular arrhythmia burden progressively declined during COVID-19 (P < 0.001). The proportion of patients with ventricular arrhythmias amongst the high COVID-19 incidence states was significantly reduced compared with those in low incidence states [odds ratio 0.61, 95% confidence interval (CI) 0.54–0.69, P < 0.001]. Comparing patients remotely monitored during both COVID-19 and control periods (n = 2458), significantly fewer ventricular arrhythmias occurred during COVID-19 [incident rate ratio (IRR) 0.68, 95% CI 0.58–0.79, P < 0.001]. This difference persisted when comparing the 1719 patients monitored during both the COVID-19 and seasonal control periods (IRR 0.69, 95% CI 0.56–0.85, P < 0.001). Conclusions: During COVID-19, there was a 32% reduction in ventricular arrhythmias needing device therapies, coinciding with measures of social isolation. There was a 39% reduction in the proportion of patients with ventricular arrhythmias in states with higher COVID-19 incidence. These findings highlight the potential role of real-life stressors in ventricular arrhythmia burden in individuals with ICDs.
dc.description.statementofresponsibilityCatherine J O’Shea, Gijo Thomas, Melissa E Middeldorp, Curtis Harper, Adrian D Elliott, Noemi Ray ... et al.
dc.identifier.citationEuropean Heart Journal, 2021; 42(5):520-528
dc.identifier.doi10.1093/eurheartj/ehaa893
dc.identifier.issn0195-668X
dc.identifier.issn1522-9645
dc.identifier.orcidThomas, G. [0000-0002-2307-1560]
dc.identifier.orcidMiddeldorp, M.E. [0000-0002-4106-9771]
dc.identifier.orcidElliott, A.D. [0000-0002-5951-4239]
dc.identifier.orcidLau, D.H. [0000-0001-7753-1318] [0000-0002-1564-439X]
dc.identifier.orcidSanders, P. [0000-0003-3803-8429]
dc.identifier.urihttp://hdl.handle.net/2440/130971
dc.language.isoen
dc.publisherOxford University Press
dc.rightsPublished on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.
dc.source.urihttps://doi.org/10.1093/eurheartj/ehaa893
dc.subjectCOVID-19; implantable cardioverter-defibrillator; ventricular arrhythmia; ventricular tachycardia, Ventricular fibrillation; remote monitoring
dc.titleVentricular arrhythmia burden during the coronavirus disease 2019 (COVID-19) pandemic
dc.typeJournal article
pubs.publication-statusPublished

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