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Ventricular arrhythmias among patients with implantable cardioverter defibrillator during the COVID-19 epidemic: Insights from the Italian frontline
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  • Giovanni Malanchini,
  • Paola Ferrari,
  • Cristina Leidi,
  • Michele Senni,
  • Paolo De Filippo
Giovanni Malanchini
ASST Papa Giovanni XXIII
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Paola Ferrari
Ospedale Papa Giovanni XXIII
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Cristina Leidi
ASST Papa Giovanni XXIII
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Michele Senni
ASST Papa Giovanni XXIII
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Paolo De Filippo
Ospedale Papa Giovanni XXIII
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Abstract

Background— According to published evidence, Coronavirus Disease‐2019 (COVID‐19) is associated with myocardial injury and could lead to higher risk of arrhythmic complications. However, there is a substantial lack of wide population data on the arrhythmogenic effect of the disease. Objective—to describe the effect of COVID-19 epidemic on arrhythmic burden among high risk patients Methods— This cross-sectional comparative study describes the incidence of ventricular arrhythmia (VA) during the epidemic outbreak (study period) and compares it to the same timeframe in 2019 (reference period). Inclusion criteria were age (>18 years) and having an implantable cardiac defibrillator (ICD). Results – Among 455 patients (mean age 64.9 ± 15.7 years), 25.1% were females and 39.6% had a CRTD. In the study period, 45 (9.9%) patients experienced a total of 86 VA; 8 patients (1.7%) required anti-tachycardia-pacing (ATP) and 6 (1.3%) at least one shock. In the reference period, a total of 69 events occurred in 36 patients (7.9%). 6 patients (1.3%) required ATP and 3 (0.7%) at least one shock. The number of patients that suffered from any arrhythmic events in the study period (9.9 vs 7.9%) did not significantly differ from the reference period (χ2 = 1.09, p = 0.29). The main predictor of VA during COVID-19 epidemic was previous history of any ICD therapy (OR = 3.84, p < 0.001). Conclusions – No evidence of increase of arrhythmic burden was found during COVID-19 epidemic. The present study contributes to illustrate the impact of the COVID-19 on the cardiovascular system.