Impact of the COVID-19 Pandemic on a Tertiary-Level Electrophysiology Laboratory in Italy

Compagnucci, Paolo; Volpato, Giovanni; Pascucci, Riccardo; Falanga, Umberto; Misiani, Agostino; Molini, Silvano; Spinucci, Giulio; Cipolletta, Laura; Conti, Manuel; Grifoni, Gino; Carboni, Laura; Perna, Gian Piero; Münch, Christopher; Eusanio, Marco Di; Capucci, Alessandro; Casella, Michela; Guerra, Federico; Russo, Antonio Dello

doi:10.1161/circep.120.008774

Cited by 15 publications

(11 citation statements)

References 5 publications

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“…Two recent small retrospective studies in Italy suggested a fall in PM placements. 17 , 18 In Germany, a retrospective analysis of claims data showed a significant decrease in emergency hospitalizations for heart rhythm disorders (including bradycardia) and a reduction of cardiac rhythm management procedures (composite of PM and ICDs). 16 To further support the prior findings, in our study, we provide prospectively collected data for the past 4 years to account for temporal variations/trends detailed analysis type of device.…”

Section: Discussionmentioning

confidence: 99%

Reduction in new cardiac electronic device implantations in Catalonia during COVID-19

et al. 2021

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Aims During the COVID-19 pandemic, concern regarding its effect on the management of non-communicable diseases has been raised. However, there are no data on the impact on cardiac implantable electronic devices (CIED) implantation rates. We aimed to determine the impact of SARS-CoV2 on the monthly incidence rates and type of pacemaker (PM) and implantable cardiac defibrillator (ICD) implantations in Catalonia before and after the declaration of the state of alarm in Spain on 14 March 2020. Methods and results Data on new CIED implantations for 2017–20 were prospectively collected by nine hospitals in Catalonia. A mixed model with random intercepts corrected for time was used to estimate the change in monthly CIED implantations. Compared to the pre-COVID-19 period, an absolute decrease of 56.5% was observed (54.7% in PM and 63.7% in ICD) in CIED implantation rates. Total CIED implantations for 2017–19 and January and February 2020 was 250/month (>195 PM and >55 ICD), decreasing to 207 (161 PM and 46 ICD) in March and 131 (108 PM and 23 ICD) in April 2020. In April 2020, there was a significant fall of 185.25 CIED implantations compared to 2018 [95% confidence interval (CI) 129.6–240.9; P < 0.001] and of 188 CIED compared to 2019 (95% CI 132.3–243.7; P < 0.001). No significant differences in the type of PM or ICD were observed, nor in the indication for primary or secondary prevention. Conclusions During the first wave of the COVID-19 pandemic, a substantial decrease in CIED implantations was observed in Catalonia. Our findings call for measures to avoid long-term social impact.

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Section: Discussionmentioning

confidence: 99%

Reduction in new cardiac electronic device implantations in Catalonia during COVID-19

et al. 2021

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“…If there is evidence of myocarditis, the return to sports should be assessed as detailed above. The return to sports activity must also consider the severity of the SARS-Cov-2 infection [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases

et al. 2021

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The prediction and prevention of sudden cardiac death is the philosopher’s stone of clinical cardiac electrophysiology. Sports can act as triggers of fatal arrhythmias and therefore it is essential to promptly frame the athlete at risk and to carefully evaluate the suitability for both competitive and recreational sports activity. A history of syncope or palpitations, the presence of premature ventricular complexes or more complex arrhythmias, a reduced left ventricular systolic function, or the presence of known or familiar heart disease should prompt a thorough evaluation with second level examinations. In this regard, cardiac magnetic resonance and electrophysiological study play important roles in the diagnostic work-up. The role of genetics is increasing both in cardiomyopathies and in channelopathies, and a careful evaluation must be focused on genotype positive/phenotype negative subjects. In addition to being a trigger for fatal arrhythmias in certain cardiomyopathies, sports also play a role in the progression of the disease itself, especially in the case arrhythmogenic right ventricular cardiomyopathy. In this paper, we review the latest European guidelines on sport cardiology in patients with cardiovascular diseases, focusing on arrhythmic risk stratification and the management of cardiomyopathies and channelopathies.

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“…A thorough patient evaluation, including CMR, and (EVM-guided) EMB is key for successful management and can provide essential data for the safe assessment of sports eligibility and for the estimation of prognosis. The care athletes with myocarditis or chronic ICM is best accomplished in centers with considerable expertise [ 60 ], given the multiple challenges encountered in the diagnosis, treatment, and follow-up of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the potential risk of cardiovascular sequelae [ 59 ] which are sometimes related to myocardial inflammation, expert consensus recommendations for the management of competitive athletes after COVID-19 have been recently provided [ 60 ]. According to these recommendations, athletes with asymptomatic or mildly symptomatic SARS-CoV-2 infection should gradually resume exercising after 10 days of complete abstinence, whereas among athletes with prior moderate–severe COVID-19, a full cardiovascular evaluation (including at least clinical assessment, ECG, echocardiography, and troponin levels) is advocated prior to resuming training [ 61 ].…”

Section: Comprehensive Patient Carementioning

confidence: 99%

Myocardial Inflammation, Sports Practice, and Sudden Cardiac Death: 2021 Update

et al. 2021

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Myocardial inflammation is an important cause of cardiovascular morbidity and sudden cardiac death in athletes. The relationship between sports practice and myocardial inflammation is complex, and recent data from studies concerning cardiac magnetic resonance imaging and endomyocardial biopsy have substantially added to our understanding of the challenges encountered in the comprehensive care of athletes with myocarditis or inflammatory cardiomyopathy (ICM). In this review, we provide an overview of the current knowledge on the epidemiology, pathophysiology, diagnosis, and treatment of myocarditis, ICM, and myopericarditis/perimyocarditis in athletes, with a special emphasis on arrhythmias, patient-tailored therapies, and sports eligibility issues.

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Impact of the COVID-19 Pandemic on a Tertiary-Level Electrophysiology Laboratory in Italy

Cited by 15 publications

References 5 publications

Reduction in new cardiac electronic device implantations in Catalonia during COVID-19

Reduction in new cardiac electronic device implantations in Catalonia during COVID-19

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases

Myocardial Inflammation, Sports Practice, and Sudden Cardiac Death: 2021 Update

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