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Impact of COVID-19 pandemic on severe ventricular arrhythmia and ICD therapy

Abdulcebbar Sipal, Mujdat Aktas, Tayyar Akbulut, Faysal Saylik

Background and objectives: The regular clinical follow-up of the patient with the Implantable Cardioverter-Defibrillator (ICD) device was seriously affected by the COVID-19 outbreak. Due to the high risk of contamination, patients didn’t admit to the clinics for the ICD device control. It has been observed that arrhythmic events increased during the COVID-19 outbreak. In this study, we aimed to investigate the frequency of severe ventricular arrhythmias and ICD device therapy in COVID-19 patients with ICD.

Methods: In this single center-observational study, we assessed severe ventricular arrhythmias and ICD therapies by analyzing recorded data of 33 patients (24 males, 72.7%) 3 months before and after getting COVID-19 during the COVID-19 pandemic in Van, Turkey, between 15 August 2020 and 15 January 2021.

Results: Before the diagnosis of COVID-19, 6 ventricular tachycardias and 1 ventricular fibrillation episode were observed. When we analyzed the records after the diagnosis COVID-19, 17 ventricular tachycardia, and 3 ventricular fibrillation episodes were observed. Considering the ICD device therapies, 5 of these severe tachyarrhythmias were terminated by Anti-Tachycardia Pacing (ATP) and 2 with shock therapy before the diagnosis of COVID-19. After the COVID-19, 14 of them were terminated by ATP, and 6 of them were terminated by shock therapy.

Conclusion: The effects of the COVID-19 pandemic, especially on ventricular arrhythmia, have not been reported sufficiently in COVID-19 PCR (+) patients. In our study, it was observed that life-threatening ventricular arrhythmias and the ICD therapies were increased in patients with COVID-19, especially in the first month after the diagnosis of COVID-19.