Arrhythmogenic syncope leading to cardiac rhythm management procedures during COVID-19 lockdown

Abstract

Introduction: Following the coronavirus disease (COVID-19) outbreak, the Italian government adopted strict rules of lockdown and social distancing. The aim of our study was to assess admission rate for syncope leading to cardiac rhythm management (CRM) procedures in Campania, the third-mostpopulous region of Italy, during COVID-19 lockdown. Methods: Data were sourced from 14 referral hospitals in Campania from 10 th March to 4 May 2020 (lockdown period) and during the same period in 2019. Among consecutive patients hospitalized for CRM procedures during the two observational periods, we retrospectively evaluated those admitted for arrhythmogenic syncope. Admission rate and the type of hospital admission between the two observational periods were compared. Results: Among 951 consecutive patients hospitalized for CRM procedures, 204 were admitted for arrhythmogenic syncope leading to CRM procedures. A significant increase in admission was shown in 2020 compared to 2019 (26.4% vs. 18.3%; P = 0.003). Moreover, regarding the type of admission to hospitals, attendance at the emergency department (ED) significantly increased (83.5% vs. 56.1%; P < 0.001); conversely, a significant decrease in urgent unplanned hospitalizations (6.2% vs. 35.5%; P < 0.001) was observed during COVID-19 lockdown. Conclusions: The hospitalization for arrhythmogenic syncope leading to CRM procedures increased during COVID-19 lockdown.

The Impact of COVID-19 Outbreak on Syncope Units Activities in Italy: A Report from the Italian Multidisciplinary Working Group on Syncope (GIMSI)

“…Our evidences support and enhance the data which described the reduction in the hospitalization rate for percutaneous coronary intervention [5,6] and cardiac pacing procedures [7][8][9][10] during the COVID-19 pandemic; moreover, our results suggest the hypothesis that the undiagnosed TLOC episodes may have contributed to the increase in non-COVID-19 out-of-hospital mortality in Italy [11].…”

“…Italy was among the countries majorly hit by COVID-19, with more than 4,241,760 laboratory-confirmed cases by 12 July 2021 and more than 126,924 deaths [3]. Following the COVID-19 outbreak, the Italian government adopted strict rules characterized by a national lockdown, from 10 March to 4 May 2020, a partial nationwide movement restriction, mandatory mask use and social distancing as an attempt to contain the virus diffusion [4]; consequently, some changes in the pattern of hospital activities or admissions for cardiovascular conditions have been observed [5][6][7][8][9][10]. A Syncope Unit (SU) is a facility featuring a standardized approach to the diagnosis and management of transient lack of consciousness (TLOC) and related symptoms, with dedicated staff and access to appropriate diagnostics and therapies [11].…”

Effects of Covid-19 Lockdown on Patients with Implantable Cardioverter-Defibrillators in South of Italy: possible causes?

“…Recently a significant reduction of 47% in diagnosis of new-onset cases of atrial fibrillation (AF) was observed in the danish adult population during national lockdown in Denmark, suggesting that the risk of complications of non-diagnosed AF could rise significantly and influence the outcome unfavourably 3 . Furthermore an increase of admissions to emergency department caused by rhythm disturbances has ben recently observed in our region during lockdown period, despite a reduction in dysrhythmia-related urgent unplanned hospitalization 4 .…”

Effusive pericarditis in the pathogenesis of cardiac arrhythmias in COVID-19: a case series

“…Подозрение на тампонаду относительно небольшим объемом экссудата, как причину обмороков, как правило, не возникает. Следует отметить, что обращаемость в связи синкопальными и пресинкопальными состояниями значительно возросла во время пандемии [14]. По данным целого ряда авторов обмороки встречаются у 1,8-3,7% болеющих COVID-19 [15,16], головокружение и предобмороки у 6,1% [16].…”