Introduction
In December 2019 a new Severe Acute Respiratory Syndrome Coronavirus 2
(SARS‐CoV‐2) emerged as leading cause of morbidity and mortality in
Wuhan, China. Its manifestations known as Coronavirus Disease‐2019
(COVID‐19), suddenly became a major concern for physicians of every
specialty (1-2).
COVID‐19 clinical manifestations are mainly respiratory, but major
cardiac complications have been reported in a considerable number of
cohorts of hospitalized patients (3, 4). A more negative outcome was
observed among patients admitted to intensive care units in Italy if
cardiovascular risk factors (e.g. hypertension) was present at baseline
(5).
Studies have linked COVID‐19 to myocardial injury, suggesting that it
could lead to a higher risk of arrhythmic complications (1).
Patients with underling heart disease, especially those considered at
higher risk for cardiac arrhythmia, are routinely implanted, according
to Guidelines (6-9), with prophylactic implantable cardioverter
defibrillator (ICD).
Previous studies have reported seasonal variation, associated with
influenza-virus spread, in the occurrence of ventricular arrhythmias
(VA) in patients with implantable cardiac defibrillator: during high
influenza activity periods, patients were more likely to have a VA
treated with shock or anti-tachycardia pacing (ATP) (10, 11).
There is a substantial lack of data from a wider population with history
of cardiac diseases on the possible arrhythmogenic effects of the
COVID-19 pandemic. The current study aims to: (1) Characterize the
burden of ventricular arrhythmia attributable to COVID-19 among patients
with an ICD during the epidemic outbreak in Italy, focusing on the
period between February 21st and April
5th 2020; and (2) Compare the incidence of VA during
the COVID-19 outbreak to that observed during the same timeframe the
previous year (February 21st and April
5th 2019).