Top

Published in:

01-11-2020 | ICD Implantation | IM - ORIGINAL

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Authors: Giuseppe Boriani, Pietro Palmisano, Federico Guerra, Matteo Bertini, Gabriele Zanotto, Carlo Lavalle, Pasquale Notarstefano, Michele Accogli, Giovanni Bisignani, Giovanni Battista Forleo, Maurizio Landolina, Antonio D’Onofrio, Renato Ricci, Roberto De Ponti, AIAC Ricerca Network Investigators

Published in: Internal and Emergency Medicine | Issue 8/2020

Abstract

COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March–April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy.

Available only for authorised users

Moirano G, Richiardi L, Novara C, Maule M (2020) Approaches to daily monitoring of the SARS-CoV-2 outbreak in Northern Italy. Front Public Health 8:222CrossRef

Bedford J, Enria D, Giesecke J, Heymann DL, Ihekweazu C, Kobinger G, Lane HC, Memish Z, Oh MD, Sall AA, Schuchat A, Ungchusak K, Wieler LH, WHO Strategic, and Technical Advisory Group for Infectious Hazards (2020) COVID-19: towards controlling of a pandemic. Lancet 395:1015–1018CrossRef

COVID-19 ITALIA (2020) Data from Italian Civil Protection Department. https://opendatadpc.maps.arcgis.com/apps/opsdashboard/in. Accessed 27 June 2020.

Barach P, Fisher SD, Adams MJ, Burstein GR, Brophy PD, Kuo DZ, Lipshultz SE (2020) Disruption of healthcare: Will the COVID pandemic worsen non-COVID outcomes and disease outbreaks? Prog Pediatr Cardiol. 2020;101254. https://doi.org/10.1016/j.ppedcard.2020.101254

De Rosa S, Spaccarotella C, Basso C, Calabrò MP, Curcio A, Filardi PP, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Sinagra G, Indolfi C, Società Italiana di Cardiologia, and the CCU Academy investigators group (2020) Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 41:2083–2088

Baldi E, Sechi GM, Mare C, Canevari F, Brancaglione A, Primi R, Klersy C, Palo A, Contri E, Ronchi V, Beretta G, Reali F, Parogni P, Facchin F, Rizzi U, Bussi D, Ruggeri S, Oltrona Visconti L, Savastano S; Lombardia CARe researchers (2020) COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. [published online ahead of print, 2020 Jun 20]. Eur Heart J. 2020;ehaa508. https://doi.org/10.1093/eurheartj/ehaa508

Censimento delle strutture aritmologiche italiane AIAC 2019. https://aiac.it/attivita/censimenti/. Accessed 18 June 2020.

Temporelli PL, Tilz RR, Arbelo E, Dagres N, Laroche C, Crijns HJ, Blomstrom-Lundqvist C, Kirchhof P, Lip GYH, Boriani G, Pokushalov E, Nakou E, Brugada J, Tavazzi L (2019) Clinical characteristics of heart failure patients undergoing atrial fibrillation ablation today in Europe. Data from the atrial fibrillation registries of the European Society of Cardiology and the European Heart Rhythm Association. Eur J Heart Fail 21:690–693CrossRef

Maltoni S, Negro A, Camerlingo MD, Pecoraro V, Sassone B, Biffi M, Boriani G (2018) Comparison of cryoballoon and radiofrequency ablation techniques for atrial fibrillation: a meta-analysis. J Cardiovasc Med (Hagerstown) 19:725–738CrossRef

10.

Matta M, Anselmino M, Ferraris F, Scaglione M, Gaita F (2018) Cryoballoon vs radiofrequency contact force ablation for paroxysmal atrial fibrillation: a propensity score analysis. J Cardiovasc Med (Hagerstown) 19:141–147CrossRef

11.

Stabile G, Bertaglia E, Guerra F, Palmisano P, Berisso MZ, Soldati E, Bisignani G, Forleo GB, Zanotto G, Landolina M, De Ponti R, Boriani G, Registro RRP, Ablazioni I, Associazione Italiana di Aritmologia e Cardiostimolazione (2017) 2017 Catheter Ablation Registry of the Italian Association of arrhythmology and cardiac pacing. G Ital Cardiol (Rome) 2019(20):590–592

12.

Perlini S, Canevari F, Cortesi S, Sgromo V, Brancaglione A, Contri E, Pettenazza P, Salinaro F, Speciale F, Sechi G, Mare C, Cutti S, Novelli V, Marena C, Muzzi A, Bruno R, Palo A, COVID19 IRCCS San Matteo Pavia Task Force (2020) Emergency Department and Out-of-Hospital Emergency System (112-AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre. Intern Emerg Med. 2020;15(5):825–833. CrossRef

13.

Bellan M, Gavelli F, Hayden E, Patrucco F, Soddu D, Pedrinelli AR, Cittone MG, Rizzi E, Casciaro GF, Vassia V, Landi R, Menegatti M, Gastaldello ML, Beltrame M, Labella E, Tonello S, Avanzi GC, Pirisi M, Castello LM, Sainaghi PP (2020) Pattern of emergency department referral during the Covid-19 outbreak in Italy. Panminerva Med. https://doi.org/10.23736/S0031-0808.20.04000-8(published online ahead of print, 2020 Jun 16)CrossRef

14.

Toniolo M, Negri F, Antonutti M, Masè M, Facchin D (2020) Unpredictable fall of severe emergent cardiovascular diseases hospital admissions during the COVID-19 pandemic: experience of a single large center in Northern Italy. J Am Heart Assoc. https://doi.org/10.1161/JAHA.120.017122(Epub ahead of print)CrossRef

15.

Migliore F, Zorzi A, Gregori D, Del Monte A, Falzone PV, Verlato R, Siciliano M, Themistoclakis S, China P, Marchese D, Pasquetto G, Ignatiuk B, Cernetti C, Giacomin E, Calzolari V, Bilato C, Dalla Valle C, Frigo GM, Marinaccio L, Saccà S, Lupo A, Roncon L, Marcantoni L, Tosi A, Turiano G, Folino F, Perazzolo Marra M, Cacciavillani L, Iliceto S, Padua School of Cardiology Network (2020) Urgent pacemaker implantation rates in the veneto region of italy after the COVID-19 outbreak. Circ Arrhythm Electrophysiol 13(6):e008722. https://doi.org/10.1161/CIRCEP.120.008722(Epub 2020 May 20)CrossRef

16.

Ricci RP, Morichelli L, Porfili A, Quarta L, Sassi A (2018) Diagnostic power and healthcare resource consumption of a dedicated workflow algorithm designed to manage thoracic impedance alerts in heart failure patients by remote monitoring. J Cardiovasc Med (Hagerstown) 19:105–112

17.

Boriani G (2015) Remote monitoring of cardiac implantable electrical devices in Europe: quo vadis? Europace 17:674–676CrossRef

18.

Palmisano P, Melissano D, Zanotto G, Perego GB, Toselli T, Landolina M, Ricci RP, Italian Association of Arrhythmology, Cardiac Pacing (AIAC) (2020) Change in the use of remote monitoring of cardiac implantable electronic devices in Italian clinical practice over a 5-year period: results of two surveys promoted by the AIAC (Italian Association of Arrhythmology and Cardiac Pacing). J Cardiovasc Med (Hagerstown) 21:305–314CrossRef

19.

Zanotto G, Melissano D, Baccillieri S, Campana A, Caravati F, Maines M, Platania F, Zuccaro L, Landolina M, Berisso MZ, Boriani G, Ricci RP (2020) Intrahospital organizational model of remote monitoring data sharing, for a global management of patients with cardiac implantable electronic devices: a document of the Italian Association of Arrhythmology and Cardiac Pacing. J Cardiovasc Med (Hagerstown) 21:171–181CrossRef

20.

Boriani G, Diemberger I, Martignani C, Biffi M, Valzania C, Bertini M, Domenichini G, Saporito D, Ziacchi M, Branzi A (2008) Telecardiology and remote monitoring of implanted electrical devices: the potential for fresh clinical care perspectives. J Gen Intern Med 23(Suppl 1):73–77CrossRef

21.

Ziacchi M, Palmisano P, Biffi M, Ricci RP, Landolina M, Zoni-Berisso M, Occhetta E, Maglia G, Botto G, Padeletti L, Boriani G, Italian Association of Arrhythmology, and Cardiac Pacing (AIAC) (2018) Clinically oriented device programming in bradycardia patients: part 1 (sinus node disease). Proposals from AIAC (Italian Association of Arrhythmology and Cardiac Pacing). J Cardiovasc Med (Hagerstown). 19:161–169CrossRef

22.

Palmisano P, Ziacchi M, Biffi M, Ricci RP, Landolina M, Zoni-Berisso M, Occhetta E, Maglia G, Botto G, Padeletti L, Boriani G, Italian Association of Arrhythmology, and Cardiac Pacing (AIAC) (2018) Clinically oriented device programming in bradycardia patients: part 2 (atrioventricular blocks and neurally mediated syncope). Proposals from AIAC (Italian Association of Arrhythmology and Cardiac Pacing). J Cardiovasc Med (Hagerstown) 19:170–180CrossRef

23.

Russo V, Nigro G, D’Onofrio A (2020) COVID-19 and cardiac implantable electronic device remote monitoring: crocodile tears or new opportunity? Expert Rev Med Devices 17:471–472CrossRef

24.

Slotwiner D, Varma N, Akar JG, Annas G, Beardsall M, Fogel RI, Galizio NO, Glotzer TV, Leahy RA, Love CJ, McLean RC, Mittal S, Morichelli L, Patton KK, Raitt MH, Ricci RP, Rickard J, Schoenfeld MH, Serwer GA, Shea J, Varosy P, Verma A, Yu CM (2015) HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm 12:e69–e100CrossRef

25.

Boriani G, Da Costa A, Ricci RP, Quesada A, Favale S, Iacopino S, Romeo F, Risi A, di Mangoni S, Stefano L, Navarro X, Biffi M, Santini M, Burri H, MORE-CARE Investigators (2013) The MOnitoring Resynchronization dEvices and CARdiac patiEnts (MORE-CARE) randomized controlled trial: phase 1 results on dynamics of early intervention with remote monitoring. J Med Internet Res 15:e167CrossRef

26.

Santini L, D'Onofrio A, Dello Russo A, Calò L, Pecora D, Favale S, Petracci B, Molon G, Bianchi V, De Ruvo E, Ammirati F, La Greca C, Campari M, Valsecchi S, Capucci A (2020) Prospective evaluation of the multisensor HeartLogic algorithm for heart failure monitoring. Clin Cardiol. https://doi.org/10.1002/clc.23366CrossRef

27.

Artico J, Zecchin M, Zorzin Fantasia A, Skerl G, Ortis B, Franco S, Albani S, Barbati G, Cristallini J, Cannata' A, Sinagra G (2019) Long-term patient satisfaction with implanted device remote monitoring: a comparison among different systems. J Cardiovasc Med (Hagerstown) 20(8):542–550CrossRef

28.

de Moraes ERFL, Cirenza C, Lopes RD, Carvalho AC, Guimaraes PO, Rodrigues AAE, de Paola AAV (2019) Prevalence of atrial fibrillation and stroke risk assessment based on telemedicine screening tools in a primary healthcare setting. Eur J Intern Med 67:36–41CrossRef

29.

Austin JM, Kachalia A (2020) The state of health care quality measurement in the era of COVID-19: the importance of doing better. JAMA. https://doi.org/10.1001/jama.2020.11461CrossRef

30.

Padula MS, D'Ambrosio GG, Tocci M, D'Amico R, Banchelli F, Angeli L, Scarpa M, Capelli O, Cricelli C, Boriani G (2019) Home care for heart failure: can caregiver education prevent hospital admissions? A randomized trial in primary care. J Cardiovasc Med (Hagerstown) 20:30–38CrossRef

31.

Varma N, Marrouche NF, Aguinaga L, Albert CM, Arbelo E, Choi JI, Chung MK, Conte G, Dagher L, Epstein LM, Ghanbari H, Han JK, Heidbuchel H, Huang H, Lakkireddy DR, Ngarmukos T, Russo AM, Saad EB, Saenz Morales LC, Sandau KE, Sridhar ARM, Stecker EC, Varosy PD. HRS/EHRA/APHRS/LAHRS/ACC/AHA worldwide practice update for telehealth and arrhythmia monitoring during and after a pandemic. [published online ahead of print, 2020 Jun 11]. Heart Rhythm. 2020;S1547-5271(20)30552-X. https://doi.org/10.1016/j.hrthm.2020.06.010

32.

Gulizia MM, Cemin R, Colivicchi F, De Luca L, Di Lenarda A, Boriani G, Di Pasquale G, Nardi F, Scherillo M, Lucci D, Fabbri G, Maggioni AP, BLITZ-AF Investigators (2019) Management of atrial fibrillation in the emergency room and in the cardiology ward: the BLITZ AF study. Europace 21(2):230–238. https://doi.org/10.1093/europace/euy166CrossRef

33.

Boriani G, Diemberger I, Martignani C, Biffi M, Branzi A (2006) The epidemiological burden of atrial fibrillation: a challenge for clinicians and health care systems. Eur Heart J 27:893–894CrossRef

34.

Marietta M, Banchelli F, Pavesi P, Manotti C, Quintavalla R, Sinigaglia T, Guazzaloca G, Pattacini C, Urbinati S, Malavasi VL, Boriani G, Voci C, D'Amico R, Magrini N (2019) Direct oral anticoagulants vs non-vitamin K antagonist in atrial fibrillation: a prospective, propensity score adjusted cohort study. Eur J Intern Med 62:9–16CrossRef

35.

Boriani G, Proietti M, Laroche C, Diemberger I, Popescu MI, Riahi S, Shantsila A, Dan GA, Tavazzi L, Maggioni AP, Lip GYH, EORP-AF Pilot General Registry Investigators (2018) Changes to oral anticoagulant therapy and risk of death over a 3-year follow-up of a contemporary cohort of European patients with atrial fibrillation final report of the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) pilot general registry. Int J Cardiol 271:68–74CrossRef

36.

Proietti M, Laroche C, Nieuwlaat R, Crijns HJGM, Maggioni AP, Lane DA, Boriani G, Lip GYH, EORP-AF General Pilot Registry; Euro Heart Survey on AF Investigators (2018) Increased burden of comorbidities and risk of cardiovascular death in atrial fibrillation patients in Europe over ten years: a comparison between EORP-AF pilot and EHS-AF registries. Eur J Intern Med 55:28–34CrossRef

37.

Diemberger I, Fantecchi E, Reggiani MLB, Martignani C, Angeletti A, Massaro G, Ziacchi M, Biffi M, Lip GYH, Boriani G (2018) Atrial fibrillation and prediction of mortality by conventional clinical score systems according to the setting of care. Int J Cardiol 261:73–77CrossRef

38.

Vitolo M, Proietti M, Harrison S, Lane DA, Potpara TS, Boriani G, Lip GYH (2020) The Euro Heart Survey and EURObservational Research Programme (EORP) in atrial fibrillation registries: contribution to epidemiology, clinical management and therapy of atrial fibrillation patients over the last 20 years. Intern Emerg Med. https://doi.org/10.1007/s11739-020-02405-0CrossRef

39.

Proietti M, Marzona I, Vannini T, Tettamanti M, Fortino I, Merlino L, Basili S, Mannucci PM, Boriani G, Lip GYH, Roncaglioni MC, Nobili A (2019) Long-term relationship between atrial fibrillation, multimorbidity and oral anticoagulant drug use. Mayo Clin Proc 94:2427–2436CrossRef

40.

Boriani G, Proietti M, Laroche C, Fauchier L, Marin F, Nabauer M, Potpara T, Dan GA, Kalarus Z, Tavazzi L, Maggioni AP, Lip GYH (2019) Association between antithrombotic treatment and outcomes at 1-year follow-up in patients with atrial fibrillation: the EORP-AF General Long-Term Registry. Europace 21:1013–1022CrossRef

41.

Keller K, Hobohm L, Münzel T, Ostad MA (2019) Syncope in the German Nationwide inpatient sample—syncope in atrial fibrillation/flutter is related to pulmonary embolism and is accompanied by higher in-hospital mortality. Eur J Intern Med 62:29–36CrossRef

42.

De Simone V, Zanotto G, Guarisse P, Venturato A, Cassinadri E, Bassi M, Bozzolin M, Tondelli S, Giacopelli D, Morando G (2019) Effects of remote monitoring of cardiac implantable electronic devices after stroke or transient ischemic attack. J Cardiovasc Med (Hagerstown) 20(8):551–556CrossRef

43.

Mazza A, Bendini MG, Valsecchi S, Lovecchio M, Leggio M, De Cristofaro R, Boriani G (2019) Occurrence of atrial fibrillation in pacemaker patients and its association with sleep apnea and heart rate variability. Eur J Intern Med 68:13–17CrossRef

44.

Vergara P, Casella M, Barbato G, De Ruvo E, Grandinetti G, Notarstefano P, Tola G, Calvi V, Santini L, Nissardi V, Nonis A, Ricci RP, Boriani G, Tondo C, Della BP (2019) Nationwide survey on the current practice of ventricular tachycardia ablation. J Cardiovasc Med (Hagerstown) 20(9):597–605CrossRef

45.

Palmisano P, Ziacchi M, Belotti G, Rapacciuolo A, Santini L, Stabile G, Berisso MZ, De Ponti R, Landolina M, Ricci RP, Boriani G, for AIAC Ricerca Investigators (2019) Clinical and organizational management of cardiac implantable electronic device replacements: an Italian Survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing). J Cardiovasc Med (Hagerstown) 20:531–541CrossRef

46.

Proclemer A, Zecchin M, D'Onofrio A, Boriani G, Ricci RP, Rebellato L, Ghidina M, Bianco G, Bernardelli E, Miconi A, Zorzin AF, Gregori D, Registro Italiano Pacemaker e Defibrillatori—Bollettino Periodico; Associazione Italiana di Aritmologia e Cardiostimolazione (2018) The pacemaker and implantable cardioverter-defibrillator registry of the Italian Association of Arrhythmology and Cardiac Pacing—annual report 2018. G Ital Cardiol (Rome) 2020(21):157–169

47.

Poli S, Boriani G, Zecchin M, Facchin D, Gasparini M, Landolina M, Ricci RP, Lanera C, Gregori D, Proclemer A (2019) Favorable trend of implantable cardioverter-defibrillator service life in a large single-nation population: insights from 10-year analysis of the Italian Implantable Cardioverter-Defibrillator Registry. J Am Heart Assoc 8(15):e012759. https://doi.org/10.1161/JAHA.119.012759CrossRef

48.

Malavasi VL, De Marco G, Imberti JF, Placentino F, Vitolo M, Mazzeo E, Cicoria G, Casali E, Turco V, Lohr F, Boriani G (2019) Radiotherapy-induced malfunctions of cardiac implantable electronic devices in cancer patients. Intern Emerg Med. https://doi.org/10.1007/s11739-019-02240-y(Epub ahead of print)CrossRef

49.

Gullón A, Formiga F, Díez-Manglano J, Mostaza JM, Cepeda JM, Pose A, Castiella J, Suárez-Fernández C, NONAVASC study group Vascular Risk Group of the Spanish Society of Internal Medicine (2019) Influence of frailty on anticoagulant prescription and clinical outcomes after 1-year follow-up in hospitalised older patients with atrial fibrillation. Intern Emerg Med 14(1):59–69CrossRef

50.

Boriani G, Maniadakis N, Auricchio A, Müller-Riemenschneider F, Fattore G, Leyva F, Mantovani L, Siebert M, Willich SN, Vardas P, Kirchhof P (2013) Health technology assessment in interventional electrophysiology and device therapy: a position paper of the European Heart Rhythm Association. Eur Heart J 34:1869–1874CrossRef

Title: Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)
Authors: Giuseppe Boriani
Pietro Palmisano
Federico Guerra
Matteo Bertini
Gabriele Zanotto
Carlo Lavalle
Pasquale Notarstefano
Michele Accogli
Giovanni Bisignani
Giovanni Battista Forleo
Maurizio Landolina
Antonio D’Onofrio
Renato Ricci
Roberto De Ponti
AIAC Ricerca Network Investigators
Publication date: 01-11-2020
Publisher: Springer International Publishing
Keywords: ICD Implantation
Atrial Fibrillation
COVID-19
Pacemaker
Pacemaker
Pacemaker
Implantable Cardioverter Defibrillator
Implantable Cardioverter Defibrillator
ICD Implantation
ICD Implantation
Published in: Internal and Emergency Medicine / Issue 8/2020
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-020-02487-w

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2020

The SARS-CoV-2 receptor, ACE-2, is expressed on many different cell types: implications for ACE-inhibitor- and angiotensin II receptor blocker-based cardiovascular therapies: comment

Medical professionalism in times of COVID-19 pandemic: is economic logic trumping medical ethics?

COVID-19, coagulopathy and venous thromboembolism: more questions than answers

Telemedicine in the acute care setting during the COVID-19 pandemic

How cardiologists respond to COVID-19: the experience of West China Hospital, China

Early predictors of in-hospital mortality in patients with COVID-19 in a large American cohort

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page