Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey

Oholi Tovia-Brodie, Moshe Rav Acha, Bernard Belhassen, Alessio Gasperetti, Marco Schiavone, Giovanni Battista Forleo, Milton E. Guevara-Valdivia, David Valdeolivar Ruiz, Nicolas Lellouche, David Hamon, Davide Castagno, Matteo Bellettini, Gaetano M. De Ferrari, Mikael Laredo, Jean Baptiste Carvès, Barbara Ignatiuk, Giampaolo Pasquetto, Paolo De Filippo, Giovanni Malanchini, Behzad B. PavriCraig Raphael, Luigi Rivetti, Roberto Mantovan, Jason Chinitz, Melissa Harding, Giuseppe Boriani, Edoardo Casali, Elaine Y. Wan, Angelo Biviano, Carlos Macias, Stepan Havranek, Pietro Enea Lazzerini, Antonio M. Canu, Marco Zardini, Giulio Conte, Óscar Cano, Michela Casella, Boris Rudic, Alexander Omelchenko, Nilesh Mathuria, Gaurav A. Upadhyay, Asaf Danon, Arie Lorin Schwartz, Philippe Maury, Shiro Nakahara, Gustavo Goldenberg, Nicolas Schaerli, Sergiy Bereza, Angelo Auricchio, Michael Glikson, Yoav Michowitz

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown. Objective: The purpose of this study was to gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey. Methods: Fifty-three centers from 13 countries across 4 continents provided information on 166 patients with known active COVID-19 who underwent a CIED procedure. Results: The CIED procedure rate in 133,655 hospitalized COVID-19 patients ranged from 0 to 16.2 per 1000 patients (P <.001). Most devices were implanted due to high-degree/complete atrioventricular block (112 [67.5%]) or sick sinus syndrome (31 [18.7%]). Of the 166 patients in the study survey, the 30-day complication rate was 13.9% and the 180-day mortality rate was 9.6%. One patient had a fatal outcome as a direct result of the procedure. Differences in patient and procedural characteristics and outcomes were found between Europe and North America. An older population (76.6 vs 66 years; P <.001) with a nonsignificant higher complication rate (16.5% vs 7.7%; P = .2) was observed in Europe vs North America, whereas higher rates of critically ill patients (33.3% vs 3.3%; P <.001) and mortality (26.9% vs 5%; P = .002) were observed in North America vs Europe. Conclusion: CIED procedure rates during known active COVID-19 disease varied greatly, from 0 to 16.2 per 1000 hospitalized COVID-19 patients worldwide. Patients with active COVID-19 infection who underwent CIED implantation had high complication and mortality rates. Operators should take these risks into consideration before proceeding with CIED implantation in active COVID-19 patients.

Original languageEnglish
Pages (from-to)206-216
Number of pages11
JournalHeart Rhythm
Volume19
Issue number2
DOIs
StatePublished - Feb 2022

Keywords

  • Active COVID-19
  • Cardiac implantable electronic device procedure
  • Complications
  • Mortality
  • Personal protective equipment

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