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.