Introduction
On February 11, 2020, the World Health Organization officially named the novel coronavirus-induced illness as coronavirus disease 2019 (COVID-19). Two days later, the International Committee on Taxonomy of Viruses (ICTV) officially named the organism severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). According to the official website of the Chinese Center for Disease Control and Prevention, the number of novel coronavirus infections in China was expected to peak on December 22, 2022. Previous evidence indicates that novel coronavirus infections increase the risk of cardiovascular diseases,1 and arrhythmias are a common cardiovascular manifestation, with high incidence rates reported in patients with COVID-19.2,3
Therefore, sudden cardiac death (SCD) is increasingly becoming a major clinical and public health concern. Implantable cardioverter defibrillators (ICDs) improve survival outcomes4–7and are currently the most effective treatment option for the prevention of SCD; however, ICD shock therapy is associated with higher mortality rates.8–10 It is estimated that 20–35% of patients with an ICD will require ICD shock therapy to treat future arrhythmic events.9,11 Large clinical trials, such as the Antiarrythmics Versus Implantable Defibrillators (AVID) trial, the Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II), the Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) trial, and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) have reported even higher shock rates. Reducing the frequency of ICD shocks and avoiding inappropriate shocks are the main goals of long-term follow-up among patients with ICDs.
Recent studies indicate a significant increase in the number of ICD shocks delivered to patients with COVID-19 infection compared to the rates in the same period in previous years.12 Our center has also observed a significant increase in the frequency of ICD shocks experienced in patients hospitalized after SARS-CoV-2 infection since the peak of the epidemic in China in December 2022; however, the relationship between COVID-19 and these events has not been well-explored.
Therefore, this study aimed to analyze the characteristics of treatment in patients with ICDs following SARS-CoV-2 infection, to explore the causes of the ICD shocks, and to provide clinical management references for the treatment of patients with ICDs during future periods involving similar infectious diseases.