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.