Implantation of Cardiac Electronic Devices in Active COVID-19 Patients. Results from an International Survey

Abstract

\n Background\n Cardiac implantable electronic device (CIED) implantation rates, as well as the clinical and procedural characteristics and outcomes in patients with known active COVID-19 are unknown.\n \n Objective\n To gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey.\n \n Methods\n Fifty-three centers from 13 countries across 4 continents provided information on 166 patients with known active COVID-19 who underwent a CIED procedure.\n \n Results\n CIED procedure rate in 133,655 hospitalized COVID-19 patients ranged from 0 to 16.2 per 1000 patients (p<0.001). Most devices were implanted due to high degree / complete AV block (112, 67.5%) or sick sinus syndrome (31, 18.7%). Of the166 patients surveyed, the 30-day complication rate was 13.9% and the 180-day mortality rate was 9.6%. One patient had a lethal outcome as a direct result of the procedure. Differences in patient and procedural characteristics and outcomes were found between Europe and North America. An older population (76.6 vs. 66 years, p<0.001) with a non-significant higher complication rate (16.5% vs. 7.7%, p=0.2) were observed in Europe, while a higher rate of critically ill patients (3.3% vs. 33.3%, p<0.001) and mortality (5% vs. 26.9%, p=0.002) were observed in North America.\n \n Conclusion\n CIED procedure rates during known active COVID-19 disease varied greatly from 0 to 16.2 per 1000 hospitalized COVID-19 patients worldwide. Patients with active COVID-19 infection who underwent CIED implantation had high complication and mortality rates. Operators should take into consideration these risks prior to proceeding with CIED implantation in active COVID-19 patients.\n