de Almeida Fernandes Diogo, Cadete Rúben, António Natália, Ventura Miguel, Cristóvão João, Elvas Luís, Gonçalves Lino
Department of Cardiology Coimbra Hospital and University Centre (CHUC) Coimbra Portugal.
Faculty of Medicine University of Coimbra Coimbra Portugal.
J Arrhythm. 2021 Nov 24;38(1):137-144. doi: 10.1002/joa3.12658. eCollection 2022 Feb.
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.
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.
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 ( = .076). Patients during "lockdown" were 7.57 times more likely to present with hypotension/shock (odds ratio 7.57; = .013). We also noted a higher tendency for hypotension on presentation during "lockdown" ( = .054) in comparison to 2019. In comparison to its homologous 2019 period, "postlockdown" saw more patients presenting with bradycardia ( = .026). No patients were admitted to the emergency department during "lockdown" for anomalies detected on ambulatory tests.
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.
新冠疫情导致心血管疾病患者的随访和干预减少。在葡萄牙，疫情对急诊起搏器植入率的影响很大程度上未知。我们试图分析新冠疫情对急诊起搏器植入率和患者情况的影响。
我们回顾性分析了2020年3月18日至5月17日（“封锁期”）以及2020年5月19日至7月17日（“解封后”）在我院急诊植入起搏器的180例患者的临床情况。然后将这些数据与上一年同期进行直接比较。
“封锁期”的急诊起搏器植入率低于同期（-23.7%），“解封后”的病例显著增加（与“封锁期”相比增加了106.9%；与2019年5月至7月相比增加了13.2%）。比较“封锁期”和“解封后”，临时起搏器的使用数量有增加趋势（P = 0.076）。“封锁期”的患者出现低血压/休克的可能性高7.57倍（优势比7.57；P = 0.013）。我们还注意到，与2019年相比，“封锁期”患者就诊时出现低血压的趋势更高（P = 0.054）。与2019年同期相比，“解封后”出现心动过缓的患者更多（P = 0.026）。“封锁期”没有患者因动态检查发现异常而被收入急诊科。
我们的数据表明，新冠疫情对急诊起搏器植入有实际影响。缓慢性心律失常患者发生严重并发症的风险尤其高，无论疫情如何都应寻求医疗救治。
