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Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

2022; Springer Science+Business Media; Volume: 18; Issue: 1 Linguagem: Inglês

10.1007/s11739-022-03140-4

1970-9366

Giuseppe Boriani, Federico Guerra, Roberto De Ponti, Antonio D’Onofrio, Michele Accogli, Matteo Bertini, Giovanni Bisignani, Giovanni B. Forleo, Maurizio Landolina, Carlo Lavalle, Pasquale Notarstefano, Renato Pietro Ricci, Gabriele Zanotto, Pietro Palmisano, R. Luise, Silvana De Bonis, Antonio Pangallo, Antonello Talarico, G. Maglia, V. Aspromonte, Gerardo Nigro, Valter Bianchi, Antonio Rapacciuolo, Ernesto Ammendola, F. Solimene, Giuseppe Stabile, Mauro Biffi, Matteo Ziacchi, Policlinico S. Orsola Malpighi, Davide Saporito, Edoardo Casali, Vincenzo Turco, Vincenzo Livio Malavasi, Marco Vitolo, Jacopo Francesco Imberti, Matteo Bertini, Arcispedale S. Anna, Marco Zardini, Angelo Placci, Fabio Quartieri, Nicola Bottoni, Valeria Carinci, G. Barbato, Elia De Maria, A. Borghi, Ospedale B. Ramazzini, G. Bronzetti, C. Tomasi, Giulio Boggian, Santo Virzì, Biagio Sassone, Alessandro Corzani, Paolo Sabbatani, Paolo Pastori, A. Ciccaglioni, Francesco Maria Adamo, Alberto Scaccia, A. Spampinato, N Patruno, Francesco Biscione, Claudio Cinti, Carlo Pignalberi, Leonardo Calò, Mauro Tancredi, Natale Di Belardino, Danilo Ricciardi, Filippo Maria Cauti, Pietro Rossi, M. Cardinale, G. Ansalone, Maria Lucia Narducci, Gemma Pelargonio, M. Silvetti, F. Drago, Luca Santini, F. Pentimalli, P. Pepi, F. Caravati, E. Taravelli, Giuseppina Belotti, Roberto Rordorf, Patrizio Mazzone, P. Della Bella, Silvana Rossi, L. F. Canevese, Silvia Cilloni, Lorenzo A. Doni, P. Vergara, M. Baroni, E. Perna, Andrea Gardini, Roberto W. Dal Negro, Giovanni Battista Perego, Antonio Curnis, Gianmarco Arabia, Alessandra Russo, P. Marchese, Gabriele Dell’Era, E. Occhetta, F. Pizzetti, Claudia Amellone, Massimo Giammaria, Chiara Devecchi, A. Coppolino, S. Tommasi, Matteo Anselmino, G. Coluccia, Alessandro Guido, Mariano Rillo, Zefferino Palamà, G. Luzzi, P. L. Pellegrino, M. Grimaldi, G. Grandinetti, E. Vilei, D. Potenza, Pietro Scicchitano, Stefano Favale, Vincenzo Ezio Santobuono, R. Sai, Donato Melissano, T. R. Candida, V Bonfantino, D. Di Canda, Domenico Gianfrancesco, D Carretta, Ennio Pisanò, A. Medico, R. Giaccari, R. Aste, C. Murgia, Vincenzo Nissardi, Giampaolo Sanna, G. Firetto, P. Crea, E. Ciotta, Giuseppe Sgarito, Giuseppe Caramanno, G. Ciaramitaro, A. Faraci, A. Fasheri, L. Di Gregorio, G. Campsi, G. Muscio, G. Giannola, Margherita Padeletti, Attilio Del Rosso, Pasquale Notarstefano, Martina Nesti, G. Miracapillo, Tiziana Giovannini, Paolo Pieragnoli, W. Rauhe, Massimiliano Marini, F. Guarracini, M. Ridarelli, Francesca Fedeli, Andrea Mazza, G. Zingarini, C Andreoli, G. Carreras, Alessandro Zorzi, Gabriele Zanotto, Antonio Rossillo, B. Ignatuk, F. Zerbo, Giulio Molon, Marcia Cristiane Fantinel, Francesco Zanon, L. Marcantoni, M. Zadro, M. Bevilacqua,

Cardiac electrophysiology and arrhythmias

The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care. A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March–May 2020; second: October 2020–January 2021; third: February–May 2021; fourth: June–October 2021; fifth: November 2021–February 2022) was launched. A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third–fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined. The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.