RESULTS
Patients’ demographics and clinical characteristics are described in
Table 1.
Five-hundred-seventy-four adult patients followed-up by remote
monitoring of ICD or CRT-Ds
implanted before January
1st 2019 have been retrospectively included in the
study.
Duting follow-up, 20 patients were ecluded because of VT or AF ablation
therapy, 8 patients for percutaneous mitral repair with the MitraClip
and/or transcatheter aortic valve implantation (TAVI). Furthermore 16
subjects were excluded because of issues related to remote
communication; 11 patients died during the observation period. Therefore
the data regarding 519 patients have been finally analysed and are
presented in this paper.
The mean age of the 519 patients was 67·years (±13.2) and most patients
were male (74.7%). Comorbidities were present in more half of patients,
with hypertension being the most common comorbidity, followed by
Ischemic heart disease (IHD), Chronic obstructive pulmonary disease
(COPD) and history of AF (Table 1).
In the global observation period we recorded a total of 285 arrhythmic
events in VT and VF zones that required appropriate ICD therapies; 228
episodes in VT zone and 57 episodes in VF zone; out of these 46% of
cases were treated by a DC shock, while 61% of episodes in VT zone and
35% in VF zone were successfully treated by ATP. In the global
observation period, we also counted 480 episodes of atrial arrhythmias.
During lockdown 206 arrhythmic events were recorded: 58 VTs, 13 VFs and
135 AFs; in the reference period 18, 9 and 62 VTs, VFs and AFs
respectively were observed (p= 0.0232, p= 0.0215 and 0.0004
respectively) (Table 2). The number of events in the case of both VTs
and VFs or any arrhythmias is significantly higher in lockdown period.
Furthermore, during lockdown period, 25 (4.8%) patients have showed at
least one VT or VF compared with 12 (2.3%) during reference period
(p=0.015). More specifically, at lockdown VT and VF were found in 15
(2.9%) and in 11 (2.1%) patients respectively, while at reference
period in 7 (1.3%) and 6 (1.2%) patients (p=0.06, p=0.267
respectively).
Among 461 patients in sinus rhythm at ICD implant, 38 (8.2%) and 24
(5.2%) patients have shown AF during lockdown and reference period
respectively (p=0.03). AF was the most encountered cardiac arrhythmia
detected in patients at all observation periods: 8.2% at lockdown, 5.2
% at reference and 15.6% at global period (table 3). There were no
significant statistical associations of our outcome with both age and
gender.
By comparing VT/VF and AF between the quarters occurring from March
1st 2019 and February 29th 2020,
there was no significant differences in the arrhythmic episodes
recorded.