De Simone Vincenzo, Guardalben Stefania, Guarise Paola, Padovani Nicola, Giacopelli Daniele, Zanotto Gabriele
Cardiology Ospedale Mater Salutis Legnago Italy.
Clinical unit Biotronik Italia Vimodrone Italy.
J Arrhythm. 2020 Dec 18;37(1):240-245. doi: 10.1002/joa3.12483. eCollection 2021 Feb.
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.
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.
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.
The trends of HR and TI in CIEDs recipients infected by the COVID-19 often showed early recurrent patterns before adverse clinical manifestations.
心脏植入式电子设备(CIED)接受者若感染新型冠状病毒(COVID-19),可能预后不良。我们旨在分析感染期间CIED的家庭监测(HM)系统(德国柏林百多力公司)每日传输的数据。
我们确定了接受HM随访且出现COVID-19临床表现的CIED患者。分析了以下HM变量的每日变化趋势:平均心率(HR)、身体活动、胸阻抗(TI)、室性和房性心律失常负荷。
研究队列包括10例患有急性呼吸综合征的CIED患者(中位年龄90[84-92]岁,男性占90%)。在严重临床表现出现之前,HR提前出现了10至30次/分钟的升高。在整个感染过程中,身体活动通常较低。肺水肿患者的TI降低,但大多数COVID-19患者(10例中的8例)的TI显著升高(从8至25Ω),提示与肺纤维化有关。半数患者还出现了心律失常并发症。
COVID-19感染的CIED接受者中,HR和TI的变化趋势常在不良临床表现出现之前呈现早期反复出现的模式。