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Impact of the COVID-19 lockdown in urgent pacemaker implantations: A cross-sectional study
Diogo de Almeida Fernandes1, Rúben Cadete2, Natália António1,2
1Department of Cardiology Coimbra Hospital and University Centre (CHUC) Coimbra Portugal.
Insights
The COVID-19 pandemic reduced emergent pacemaker implantations during lockdown but significantly increased them post-lockdown. Patients with bradyarrhythmias need urgent care despite the pandemic.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic disrupted cardiovascular disease care, impacting follow-up and interventions.
- The effect on emergent pacemaker implantation rates in Portugal remained unclear.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic on emergent pacemaker implantation rates.
- To examine changes in patient profiles undergoing emergent pacemaker implantation during the pandemic.
Main Methods:
- Retrospective review of 180 patients undergoing emergent pacemaker implantation.
- Comparison of data from lockdown (March-May 2020) and post-lockdown (May-July 2020) periods.
- Direct comparison with homologous periods from the previous year (2019).
Main Results:
- Emergent pacemaker implantation rates decreased by 23.7% during lockdown compared to 2019.
- Post-lockdown rates increased by 106.9% versus lockdown and 13.2% versus May-July 2019.
- Patients during lockdown were 7.57 times more likely to present with hypotension/shock; post-lockdown showed increased bradycardia presentations.
Conclusions:
- The COVID-19 pandemic significantly impacted urgent pacemaker implantation.
- Patients with bradyarrhythmias face heightened risks and require medical attention irrespective of pandemic conditions.
Aims:
The COVID-19 pandemic resulted in a decrease in patients' follow-up and interventions with cardiovascular disease. In Portugal, the consequences on emergent pacemaker implantation rates are largely unknown. We sought to analyze the impact of the COVID-19 pandemic on emergent pacemaker implantation rate and patient profile.
Methods:
We retrospectively reviewed the clinical profile of the 180 patients who had pacemakers implanted in our hospital in an emergent setting from March 18, 2020, to May 17, 2020 ("lockdown") and May 19 to July 17, 2020 ("postlockdown"). This data was then directly compared to the homologous periods from the year before.
Results:
Urgent pacemaker implantation rates during "lockdown" was lower than its homologous period (-23.7%), and cases in "postlockdown" were significantly increased (+106.9% vs. "lockdown"; +13.2% vs. May-July 2019).When comparing "lockdown" and "postlockdown," there was a tendency for a higher number of temporary pacemaker use (p = .076). Patients during "lockdown" were 7.57 times more likely to present with hypotension/shock (odds ratio 7.57; p = .013). We also noted a higher tendency for hypotension on presentation during "lockdown" (p = .054) in comparison to 2019. In comparison to its homologous 2019 period, "postlockdown" saw more patients presenting with bradycardia (p = .026). No patients were admitted to the emergency department during "lockdown" for anomalies detected on ambulatory tests.
Conclusion:
Our data show that the COVID-19 pandemic had a real impact on urgent pacemaker implantation. Patients with bradyarrhythmias are at particular risk for severe complications and should seek medical care regardless of the pandemic.
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