Biel Bartosz, Skoczyński Przemysław, Hrymniak Bruno, Jakobson Rafał, Kuliczkowski Wiktor, Obremska Marta, Sokołowski Janusz, Zyśko Dorota, Banasiak Waldemar, Jagielski Dariusz
Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland.
Kardiol Pol. 2024;82(2):156-165. doi: 10.33963/v.kp.98604. Epub 2024 Jan 17.
Implantable cardioverter-defibrillators (ICD)/cardiac resynchronization therapy with defibrillation (CRT-D) recipients may be susceptible to the arrhythmic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
We aimed to evaluate characteristics and outcomes of patients hospitalized for ICD/CRT-D shocks during the pandemic compared to the pre-pandemic period.
This retrospective study analyzed medical records of patients hospitalized for ICD/CRT-D shock in the pre-pandemic (January 1, 2018-December 31, 2019) and pandemic periods (March 4, 2020-March 3, 2022). Survival data were obtained on October 24, 2022.
In total, 198 patients (average age 65.6 years) had 138 pre-pandemic and 124 pandemic visits. Of these patients, 115 were hospitalized during pre-pandemic, 108 during the pandemic, and 25 in both periods. No significant differences were noted in age, sex, number of shocks, or appropriateness of therapy between these periods. During the pandemic, during 14 hospital stays of patients with SARS-CoV-2, 8 (57.1%) received electrical shocks, compared to 12 (10.9%) with negative SARS-CoV-2 tests (P <0.001). The in-hospital mortality rate was 2 of 115 patients hospitalized during the pre-pandemic and 7 of 108 during pandemic periods (4 patients with and 3 without SARS-CoV-2 [P = 0.10]). During the follow-up, there were 66 deaths. Cox regression analysis showed that survival decreased with age and heart failure decompensation in medical history but increased with higher ejection fraction. The pandemic alone was not a survival predictor. However, SARS-CoV-2 infection, older age, and heart failure decompensation in medical history predicted worse outcomes during the pandemic period.
The pandemic did not increase the number of hospital visits due to ICD/CRT-D discharges. SARS-CoV-2 infection predicts increased mortality in patients with ICD/CRT-D shocks.
植入式心脏复律除颤器（ICD）/心脏再同步化治疗除颤器（CRT-D）植入者可能易受严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的心律失常影响。
我们旨在评估大流行期间因ICD/CRT-D电击住院的患者与大流行前时期相比的特征和结局。
这项回顾性研究分析了大流行前（2018年1月1日至2019年12月31日）和大流行期间（2020年3月4日至2022年3月3日）因ICD/CRT-D电击住院患者的病历。生存数据于2022年10月24日获得。
总共198例患者（平均年龄65.6岁）有138次大流行前就诊和124次大流行期间就诊。其中，115例在大流行前住院，108例在大流行期间住院，25例在两个时期均住院。这些时期之间在年龄、性别、电击次数或治疗适宜性方面未发现显著差异。在大流行期间，14例SARS-CoV-2感染患者住院期间，8例（57.1%）接受了电击，而SARS-CoV-2检测阴性的患者中有12例（10.9%）接受了电击（P<0.001）。大流行前住院的115例患者中有2例院内死亡，大流行期间住院的108例患者中有7例院内死亡（4例感染SARS-CoV-2，3例未感染[P=0.10]）。随访期间有66例死亡。Cox回归分析显示，生存率随年龄和病史中心力衰竭失代偿而降低，但随射血分数升高而增加。仅大流行本身不是生存预测因素。然而，SARS-CoV-2感染、年龄较大和病史中心力衰竭失代偿预示着大流行期间结局更差。
大流行并未增加因ICD/CRT-D放电导致的住院就诊次数。SARS-CoV-2感染预示着ICD/CRT-D电击患者死亡率增加。
