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Anxiety and palpitations in patients with cardiac implantable electronic devices (CIEDs) and the added value of remote monitoring (RM) in the COVID-19 pandemic: an Italian single-centre experience
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  • TERESA STRISCIUGLIO,
  • Giuseppe Ammirati,
  • Livio Imparato,
  • Valerio Pergola,
  • Lucio Addeo,
  • Aniello Viggiano,
  • Antonio Rapacciuolo
TERESA STRISCIUGLIO
University of Naples Federico II
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Giuseppe Ammirati
University of Naples Federico II
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Livio Imparato
Federico II University Hospital
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Valerio Pergola
University of Naples Federico II
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Lucio Addeo
University of Naples Federico II
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Aniello Viggiano
University of Naples Federico II
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Antonio Rapacciuolo
Federico II University of Naples
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Abstract

Background. Mood disorders are common in patients with cardiac implantable electronic devices (CIEDs). The lockdown related to COVID-19 pandemic may have further undermined their emotional well being exacerbating physical symptoms such as palpitations. We investigated the occurrence of anxiety and palpitations in CIEDs patients during the pandemic. In those with remote monitoring (RM) available, we evaluated whether these symptoms were associated with arrhythmic events. Methods and Results. The generalized anxiety disorder (GAD) 7-items questionnaire and the frequency of palpitations were assessed by telephonic interview in CIEDs patients Overall 152 CIEDs patients agreed to be interviewed (119 males, age 69±14 years). The RM was available in 54/152 (36%). Thirtyseven (24%) and 43 (28%) patients experienced anxiety and palpitations respectively, and 23 (15%) patients experienced both. Women were more likely to have symptoms than men (50% vs. 20%; p<0.01 for anxiety and 53% vs. 24%; p<0.01 for palpitations). Among patients with palpitations the RM was available in 17/43 (40%) and revealed the following arrhythmias in 7/17 (41%) patients: 8 non-sustained ventricular tachycardias (NSVT), 2 supra-ventricular tachycardias (SVT), 4 sustained ventricular tachycardias (VT). The RM enabled to detect in 6 patients a device malfunctioning: in 2 increased impedance in the shock lead, in 3 increased capture threshold for the LV lead and in 1 the battery reached the end of life Conclusion. Patients with CIEDs during the COVID19 outbreak were likely to experience anxiety and palpitations and the RM has been pivotal to ascertain the occurrence of arrhythmic events and device malfunctioning