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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Home Monitoring trends during COVID-19 infection
Vincenzo De Simone1, Stefania Guardalben1, Paola Guarise1
1Cardiology Ospedale Mater Salutis Legnago Italy.
Insights
Cardiac implantable electronic device (CIED) patients with COVID-19 showed early warning signs in heart rate and thoracic impedance. Home monitoring data revealed trends preceding severe illness, aiding early detection in this vulnerable population.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomedical Engineering
Background:
- Cardiac implantable electronic device (CIED) recipients face risks with COVID-19 infection.
- Home Monitoring (HM) systems offer continuous data for CIED patients.
Purpose of the Study:
- To analyze daily Home Monitoring (HM) data from CIEDs in patients with COVID-19.
- To identify early warning patterns of COVID-19 infection in CIED recipients.
Main Methods:
- Identified CIED patients with COVID-19 using HM data.
- Analyzed daily trends in mean heart rate (HR), physical activity, thoracic impedance (TI), and arrhythmic burden.
Main Results:
- Included 10 CIED patients (median age 90 years, 90% male) with acute respiratory syndrome.
- Observed increased HR (10-30 bpm) preceding severe COVID-19 symptoms.
- Noted decreased TI with pulmonary edema and increased TI (8-25 Ω) in 80% of patients, suggesting pulmonary fibrosis.
- Found arrhythmic complications in 50% of patients.
Conclusions:
- Trends in HR and TI from CIEDs can indicate early patterns before adverse COVID-19 manifestations.
- HM data provides valuable insights for managing CIED patients during COVID-19 infection.
Background:
Cardiac implantable electronic device (CIED) recipients could have an unfavorable prognosis if infected with the novel coronavirus (COVID-19). We aimed to analyze the data daily transmitted by the Home Monitoring (HM) system (BIOTRONIK, Berlin, Germany) of CIEDs during the infection.
Methods:
We identified CIED patients followed with the HM who experienced COVID-19 clinical manifestations. The daily trends of the following HM variables were analyzed: mean heart rate (HR), physical activity, thoracic impedance (TI), ventricular and atrial arrhythmic burden.
Results:
The study cohort included 10 CIED patients (median age 90 [84-92] years, male 90%) with acute respiratory syndrome. The HR showed an increase of a value ranging from 10 to 30 bpm well in advance of the severe clinical manifestations. The physical activity was generally low during the entire infection course. The TI decreased in patients presented with pulmonary edema, but increased significantly (8 to 25 Ω) in most COVID-19 patients (8 out of 10) suggesting an association with pulmonary fibrosis. Arrhythmic complications were also found in half of the patients.
Conclusion:
The trends of HR and TI in CIEDs recipients infected by the COVID-19 often showed early recurrent patterns before adverse clinical manifestations.
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