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The Impact of COVID-19 Pandemic and Lockdown Restrictions on Cardiac Implantable Device Recipients with Remote

Igor Diemberger1,2, Alessandro Vicentini3, Giuseppe Cattafi4

  • 1Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy.

Journal of Clinical Medicine
|December 10, 2021
PubMed

Insights

The COVID-19 pandemic lockdown reduced physical activity and heart rate variability in patients with heart disease, increasing arrhythmia burden. These effects persisted post-lockdown, suggesting long-term impacts of pandemic restrictions on cardiac health.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • COVID-19 pandemic led to widespread restrictions, impacting healthcare and daily life for cardiac patients.
  • Implantable devices provide continuous physiological data crucial for monitoring patient health during such events.

Purpose of the Study:

  • To assess the impact of COVID-19 lockdown restrictions on cardiac function and arrhythmias in patients with implantable devices.
  • To compare device-measured parameters during lockdown, post-lockdown, and a pre-pandemic control period.

Main Methods:

  • Prospective analysis of remotely monitored data from implantable defibrillators/cardiac resynchronization devices in 696 Italian patients.
  • Comparison of device data across three periods: lockdown (LDP), post-lockdown (PLDP), and control (CP) from the previous year.
  • Categorization of patients based on high/low COVID-19 infection prevalence areas.

Main Results:

  • Significant decrease in median patient activity and heart rate variability during LDP compared to CP, with partial recovery in PLDP.
  • Increased burden of atrial and ventricular arrhythmias during LDP compared to CP; ventricular arrhythmias decreased in PLDP.
  • No significant changes in thoracic fluid levels; COVID-19 infection prevalence did not significantly impact findings.

Conclusions:

  • COVID-19 lockdown restrictions negatively impacted physical activity and heart rate variability in cardiac patients.
  • An increased arrhythmic burden was observed during lockdown, independent of infection prevalence, suggesting a direct effect of restrictions.
  • Findings highlight the detrimental cardiovascular effects of pandemic-related lifestyle changes and restrictions.

Keywords:
COVID-19arrhythmiasheart failurepandemiaphysical activitytelemonitoring

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