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Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1 Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2 It is conventionally performed via the trans-femoral (TF) route. Recently, however, the trans-radial (TR) route has become the preferred way.3 The TR route offers better procedure comfort, shorter hospitalization […]

68/How often do we need to implant cardiac devices in COVID-19 patients – data from a single COVID-19-Hospital population

B Ignatiuk (Presenting Author) - Ospedali Riuniti Padova Sud, Monselice; L Leone - Ospedali Riuniti Padova Sud, Monselice; S Da Ros - Ospedali Riuniti Padova Sud, Monselice; D Montemurro - Ospedali Riuniti Padova Sud, Monselice; G Pasquetto - Ospedali Riuniti Padova Sud, Monselice
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Published Online: Oct 3rd 2011 European Journal of Arrhythmia & Electrophysiology. 2021;7(Suppl. 1):abstr68
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Article

Background: Despite the millions of people infected by SARSCoV-2 worldwide, there have only been few reports of cardiac device implantations in such subjects.

Purpose: We report a series of patients with SARS-CoV-2 who needed a permanent pacemaker.

Methods: Study of a single public hospital population in Northern Italy, entirely converted to a COVID-19-only facility during the SARS-CoV-2 pandemic. Data retrospectively collected from electronic medical history. We analysed the clinical profiles of patients implanted with pacemakers, the procedural safety, and the follow-up data.

Results: In total, 1,168 patients were hospitalized (during the spring outbreak from 21/02/2020 to 31/05/2020, and during the autumn phase, from mid-October until the end of 2020), mean age 72 years, 42% were females. All had a positive molecular nasopharyngeal swab for SARS-CoV-2 at admission. All but 5 were admitted because of COVID-19-related pneumonia requiring oxygen supplementation. The COVID-19 treatment was standardized according to the best knowledge of the time (including hydroxychloroquine and lopinavir during the spring outbreak and plasma/remdesivir during the autumn). In-hospital mortality was 22.3%. Four patients received a transvenous pacemaker (one during the spring wave and three in the autumn phase). The clinical information is summarized in Table 1. Only one subject had an overt SARS CoV-2 pneumonia at presentation and had an underlying aortic disease. A second pacemaker was implanted because of conduction disease in a patient with only incidental positivity at swab without any clinical manifestation of COVID-19. Two patients had moderate pneumonia on HRCT, but one was implanted late after pneumonia resolution, during readmission because of bradycardia. No peri- and post-procedural complications were observed. Personnel was negative on serial swabs. Two patients died during the follow-up (five months and two weeks after implantation, respectively).

Conclusions: In this large cohort of COVID-19 patients with symptomatic pneumonia, the pacemaker implantation rate was not higher than the implant rate in the general population. The bradyarrhythmias might not be necessarily related to the SARS-CoV-2 infection. The procedure may be performed safely both for the patient and for the personnel. The outcome is related to the severity of COVID-19 disease and individual patient factors.

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