Urgent Pacemaker Implantation Rates in the Veneto Region of Italy After the COVID-19 Outbreak

Migliore, Federico; Zorzi, Alessandro; Gregori, Darío; Monte, Alvise Del; Falzone, Pasquale Valerio; Verlato, Roberto; Siciliano, Mariachiara; Themistoclakis, Sakis; China, Paolo; Marchese, Domenico; Pasquetto, Giampaolo; Ignatiuk, Barbara; Cernetti, Carlo; Giacomin, Enrico; Calzolari, Vittorio; Bilato, Claudio; Valle, Chiara Dalla; Frigo, Gianfranco; Marinaccio, Leonardo; Saccà, Salvatore; Lupo, Antonio; Roncon, Loris; Marcantoni, Lina; Tosi, Alberto; Turiano, Giovanni; Folino, Franco; Marra, Martina Perazzolo; Cacciavillani, Luisa; Iliceto, Sabino

doi:10.1161/circep.120.008722

Cited by 43 publications

(45 citation statements)

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“…A reduction up to 50% in urgent pacemaker implants for severe bradyarrhythmias was previously reported, in agreement with our national survey, by analysis performed on a single hospital basis or on a regional basis [14,15]. The reduction in urgent pacemaker implants may imply a lack of prevention for the potential harmful consequences of bradyarrhythmias and, indeed, a relative increase in the proportion of patients presenting with syncope due to bradyarrhythmias was already observed [15]. It is possible that this trend will increase also in the post-lockdown phase and it will be interesting to analyse if it will lead to a rebound in pacemaker implants.…”

Section: Discussionsupporting

confidence: 91%

“…In interpreting these findings, it should be considered that the COVID-19 outbreak markedly changed the pattern of Emergency Departments (EDs) referral in Italy, with figures up to a 50% reduction accesses to hospitals and EDs unrelated to COVID-19 [12,13]. A reduction up to 50% in urgent pacemaker implants for severe bradyarrhythmias was previously reported, in agreement with our national survey, by analysis performed on a single hospital basis or on a regional basis [14,15]. The reduction in urgent pacemaker implants may imply a lack of prevention for the potential harmful consequences of bradyarrhythmias and, indeed, a relative increase in the proportion of patients presenting with syncope due to bradyarrhythmias was already observed [15].…”

Section: Discussionsupporting

confidence: 81%

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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)

Boriani

Palmisano²,

Guerra

et al. 2020

Intern Emerg Med

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 81%

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)

Boriani

Palmisano²,

Guerra

et al. 2020

Intern Emerg Med

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“…During COVID-19 outbreak, the strict rules adopted by Italian government to contain virus diffusion, the reorganization of the healthcare model, the restructuring of hospital services might be in part responsible for the reduction trend in planned hospitalizations and elective procedures, as observed in our study population. In contrast to previous reports from Northern Italy, 7 , 8 which showed a trend of reduction in hospital admission due to cardiovascular diseases leading to cardiac pacing procedures, our data showed no significant difference in Emergency department (ED) admission rate and a remarkably increase in urgent unplanned hospitalizations for patients in need of CIEDs replacement procedures.…”

Section: Discussioncontrasting

confidence: 99%

Cardiac implantable electronic devices replacements in patients followed by remote monitoring during COVID-19 lockdown

Russo

Rapacciuolo

Pafundi

et al. 2021

European Heart Journal - Digital Health

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Aims Following coronavirus disease (COVID-19) outbreak, the Italian government adopted strict rules of lockdown and social distancing. The aim of our study was to assess the admission rate for cardiac implantable electronic devices (CIEDs) replacement procedures in Campania, the 3rd-most-populous region of Italy, during COVID-19 lockdown. Methods and results Data were sourced from 16 referral hospitals in Campania from 10 March to 4 May 2020 (lockdown period) and during the same period in 2019. We retrospectively evaluated consecutive patients hospitalized for CIEDs replacement procedures during the two observational periods. The number and type of CIEDs replacement procedures among patients followed by remote monitoring (RM), the admission rate, and the type of hospital admission between the two observational periods were compared. In total, 270 consecutive patients were hospitalized for CIEDs replacement procedures over the two observation periods. Overall CIEDs replacement procedures showed a reduction rate of 41.2% during COVID-19 lockdown. Patients were equally distributed for sex (P = 0.581), and both age [median 76 years (IQR: 68–83) vs. 79 years (IQR: 68–83); P = 0.497]. Cardiac implantable electronic devices replacement procedures in patients followed by RM significantly increased (IR: +211%; P < 0.001), mainly driven by the remarkable increase rate trend of both PM (IR: +475%; P < 0.001) and implantable cardiac defibrillator replacement procedures (IR: +67%, P = 0.01), during COVID-19 lockdown compared with 2019 timeframe. Conclusions We showed a significant increase trend rate of replacement procedures among CIEDs patients followed by RM, suggesting the hypothesis of its increased use to closely monitoring and to optimize the hospital admission time during COVID-19 lockdown.

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“…These findings suggest that the strategy of replacing in-hospital visits with “telecardiology” may be effective in the short-term management of patients. However, multiple studies reported that many Italian patients with acute cardiovascular conditions did not seek urgent medical attention during the COVID-19 outbreak [4] , [5] , [6] and this may partly explain the lower number of ED admissions we observed in 2020 than in 2019. For this reason, we believe that a longer follow-up is needed before drawing definite conclusions on the impact to the health of patients with cardiovascular diseases of the modifications of clinical practice that became necessary after the COVID-19 outbreak.…”

Section: Discussionmentioning

confidence: 81%

Short-term outcome associated with remote evaluation (telecardiology) of patients with cardiovascular diseases during the COVID-19 pandemic

Maines

Zorzi

Benetollo

et al. 2020

IJC Heart & Vasculature

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Introduction During the recent COVID-19 outbreak, Italian health authorities mandated to replace in-person outpatient evaluations with remote evaluations. Methods From March 16th 2020 to April 22th 2020, all outpatients scheduled for in-person cardiac evaluations were instead evaluated by phone. We aimed to report the short-term follow-up of 345 patients evaluated remotely and to compare it with a cohort of patients evaluated in-person during the same period in 2019. Results During a mean follow-up of 54 ± 11 days, a significantly higher proportion of patients evaluated in-person in 2019 visited the emergency department or died for any cause (39/391, 10% versus 13/345 3.7%, p = 0.001) and visited the emergency department for cardiovascular causes (19/391, 4.9% versus 7/345, 2.0%, p = 0.04) compared to 2020. No cardiovascular death was recorded in the two periods. To an evaluation with a satisfaction questionnaire 49% of patients would like to continue using remote controls in addition to traditional ones. Conclusion These findings may have important implications for the management of patients during the current COVID-19 pandemic because they suggest that remote cardiovascular evaluations may replace in-hospital visits for a limited period.

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Urgent Pacemaker Implantation Rates in the Veneto Region of Italy After the COVID-19 Outbreak

Cited by 43 publications

References 0 publications

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)

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)

Cardiac implantable electronic devices replacements in patients followed by remote monitoring during COVID-19 lockdown

Short-term outcome associated with remote evaluation (telecardiology) of patients with cardiovascular diseases during the COVID-19 pandemic

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