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Updated: Aug 24, 2025

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Cardiac implantable device interrogation in left ventricular systolic dysfunction reveals physiologic abnormalities
Matthew S Delfiner1, Matthew Bocchese1, Raj Dalsania2
1Section of Cardiology, Lewis Katz School of Medicine at Temple University, 3401 N Broad Street, Parkinson Pavilion, 9th Floor, Philadelphia, PA 19140, USA.
Background:
COVID-19 has affected individuals across the globe, and those with cardiac implantable electronic devices (CIEDs) likely represent a high-risk group. These devices can be interrogated to reveal information about the patient activity, heart rate parameters, and respiratory rate.
Case Summary:
Four patients with CIEDs and left ventricular dysfunction were admitted to a single institution for COVID-19 infection. Each patient survived hospitalization, and none required intensive care. Retrospectively, CIED interrogation revealed each patient had decreased activity level prior to their reporting COVID-19 symptoms. Similarly, respiratory rate increased before symptom onset for three of the patients, while one did not have these data available. Of the three patients with heart rate variability (HRV) available, two had decreased HRV before they developed symptoms. After hospital discharge, these parameters returned to their baseline.
Discussion:
This case series suggests physiologic changes identifiable through interrogation of CIEDs may occur prior to the reported onset of COVID-19 symptoms. These data may provide objective evidence on which to base more sensitive assessments of infectious risk when performing contact tracing in communities.
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