Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.
Europace. 2021 Mar 8;23(3):456-463. doi: 10.1093/europace/euab011.
During the COVID-19 pandemic, concern regarding its effect on the management of non-communicable diseases has been raised. However, there are no data on the impact on cardiac implantable electronic devices (CIED) implantation rates. We aimed to determine the impact of SARS-CoV2 on the monthly incidence rates and type of pacemaker (PM) and implantable cardiac defibrillator (ICD) implantations in Catalonia before and after the declaration of the state of alarm in Spain on 14 March 2020.
Data on new CIED implantations for 2017-20 were prospectively collected by nine hospitals in Catalonia. A mixed model with random intercepts corrected for time was used to estimate the change in monthly CIED implantations. Compared to the pre-COVID-19 period, an absolute decrease of 56.5% was observed (54.7% in PM and 63.7% in ICD) in CIED implantation rates. Total CIED implantations for 2017-19 and January and February 2020 was 250/month (>195 PM and >55 ICD), decreasing to 207 (161 PM and 46 ICD) in March and 131 (108 PM and 23 ICD) in April 2020. In April 2020, there was a significant fall of 185.25 CIED implantations compared to 2018 [95% confidence interval (CI) 129.6-240.9; P < 0.001] and of 188 CIED compared to 2019 (95% CI 132.3-243.7; P < 0.001). No significant differences in the type of PM or ICD were observed, nor in the indication for primary or secondary prevention.
During the first wave of the COVID-19 pandemic, a substantial decrease in CIED implantations was observed in Catalonia. Our findings call for measures to avoid long-term social impact.
在 COVID-19 大流行期间，人们对其对非传染性疾病管理的影响表示担忧。然而，目前尚无关于心脏植入式电子设备 (CIED) 植入率影响的数据。我们旨在确定在 2020 年 3 月 14 日西班牙宣布进入警戒状态之前和之后，SARS-CoV2 对加泰罗尼亚每月起搏器 (PM) 和植入式心脏除颤器 (ICD) 植入率的影响。
加泰罗尼亚的 9 家医院前瞻性收集了 2017-20 年新的 CIED 植入数据。使用具有随机截距的混合模型进行校正，以估计每月 CIED 植入的变化。与 COVID-19 前时期相比，CIED 植入率绝对下降了 56.5%（PM 下降 54.7%，ICD 下降 63.7%）。2017-19 年和 2020 年 1 月和 2 月的总 CIED 植入量为 250/月（>195 个 PM 和>55 个 ICD），3 月降至 207（161 个 PM 和 46 个 ICD），4 月降至 131（108 个 PM 和 23 个 ICD）。2020 年 4 月，与 2018 年相比，CIED 植入量下降了 185.25 个[95%置信区间 (CI) 129.6-240.9；P<0.001]，与 2019 年相比下降了 188 个 CIED[95% CI 132.3-243.7；P<0.001]。PM 或 ICD 的类型、一级或二级预防的适应证均无显著差异。
在 COVID-19 大流行的第一波中，加泰罗尼亚的 CIED 植入量大幅下降。我们的研究结果呼吁采取措施避免长期的社会影响。
