Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Abstract

COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March-April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy.

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

“…As a consequence of the disruptive effects of COVID-19 pandemic, screening for AF may become even more important in the next future. Indeed, COVID-19 caused a polarization of care on the various manifestation of SARS-CoV-2 infection and on its management [39][40][41] that coupled with the fear and psychological distress diffused within the population [42][43][44][45] led to a marked reduction in access to Emergency Departments for acute cardiovascular conditions, including new-onset AF [46][47][48][49][50]. Some data from large datasets indicate that the risk of undiagnosed AF during COVID-19 lockdown is associated with an increased occurrence of stroke, related to lack of anticoagulation in patients at risk [48], thus making of great clinical value any initiatives of opportunistic screening for detecting unknown and previously undetected AF.…”

Impact of the 2019 Novel Coronavirus Disease Pandemic on the Performance of a Cardiovascular Department in a Non-epidemic Center in Beijing, China

“…Elliott et al demonstrated a 56% reduction in elective coronary angiography (CA) and PCI ( 24 ). Furthermore, the number of patients who underwent electrophysiology procedures and those with structural heart disease who underwent invasive procedures decreased ( 25 – 27 ). These results are similar to our study.…”

Remote monitoring and telemedicine in heart failure: implementation and benefits

“…The use of RM has markedly increased in recent years, as shown by the comparison of two Italian surveys conducted in 2012 and 2017 [96]. The global COVID-19 pandemic is further boosting the RM implementation in order to keep social-distancing to the utmost [95]. However, RM is still largely underused in clinical practice [92].…”

“…Meta-analysis of randomized clinical trials on remote monitoring of cardiac implantable electronic devices from various device manufacturers: effects on mortality, hospitalizations, and visits Remote monitoring as part the multidisciplinary approach to the treatment of heart failure patients. CIEDs cardiac implantable electronic devices, EP electrophysiology, HF heart failure of COVID-19 pandemic[94,95] with need for more accurate analysis in the next future.…”