Impact of the COVID-19 pandemic on implantation of cardiac implantable electronic devices and remote monitoring activations.

Autores de IIS La Fe

• Óscar Cano Pérez

  Autor

Participantes ajenos a IIS La Fe

• Javier Garcia-Fernandez, F
• Simal, Sara Calvo
• Cuervo, David Calvo
• Jimenez, Marta Pombo
• Lozano, Ignacio Fernandez
• Tercedor, Lola Villagraz
• Palacios, Gonzalo Fernandez
• Gonzalez, Javier Martin

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

Abstract

INTRODUCTION AND OBJECTIVES: Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) is considered more reliable, efficient, and safer than conventional in-person follow-up. However, the implementation of RM is still suboptimal. This study aimed to analyze the impact of the COVID-19 pandemic on the rates of CIED implants and RM activations in Spain. METHODS: The COVID-19 RM Spain Registry was used to analyze the monthly number of all CIED implantations and RM activations from January 2018 to December 2021. A descriptive analysis was performed usingaggregateddatafrom the five majorCIEDmanufacturers. RESULTS: A total of 205345 CIEDs were recorded. The number of implants decreased sharply (48.2%) during the pandemic lockdown (March-June 2020) but gradually increased thereafter, compensating for the previous reduction. However, pacemakers and implantable cardiac defibrillators (ICD) showed an aggregate loss of 7% and 3%, respectively, from the annual average during 2020-2021. In contrast, cardiac resynchronization therapy defibrillators (CRT-D) increased by 17%, and pacemakers (CRT-P) by 4.5% over the 2-year period. The percentage of RM activations increased from 24.5% in 2018 to 49.0% in 2021, with a sharp increase during the lockdown. The RM activation rates consistently increased during the lockdown for all devices: pacemakers (14.4% vs 37.2%; P<.001); ICD (75.6% vs 94.2%; P < .001); CRT-D/CRT-P (68.6-44.2% vs 81.6-61%; P < .001), and implantable loop recorders (50.2% vs 68.7%; P < .001). CONCLUSIONS: The significant decline in implants during the lockdown gradually recovered, except for pacemakers and ICD. However, the COVID-19 pandemic boosted RM for all CIEDs in Spain.

Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Keywords

• COVID-19; Desfibrilador implantable; Dispositivos cardiacos; Marcapasos; Monitorización a distancia; Resincronización cardiaca; cardiac devices; cardiac resynchronization; implantable cardiac defibrillator; pacemaker; remote monitoring